Bone Donation

O dry bones, I will lay sinews on you,
and will cause flesh to come upon you,
and cover you with skin,
and put breath in you,
and you shall live.”

Ezekiel 37:6

Consider my visage
Weakened by disease and age -

My limbs, once strong
Yearn to hold and belong
To walk with purpose
To stretch for others

But I know…
When blood retreats my veins
And my kin my bedside
I would remain
In your arms or as you walk – It’s my decide.

Bone is the second most commonly transplanted tissue, second only to blood.

It has been estimated that over 200-300 thousand people world wide receive bone transplant every year, which is more than 25 times the number of people undergoing kidney transplant and 100 times the number who undergo cardiac transplant.

5,00,000 bone transplants take place annually in the United States.

Unlike other tissues in the body, the growth of bone tissues is quite a visible phenomenon and so is the need for it - to replace damaged, fractured and injured bones.

Bone transplants are necessitated by tumour surgeries, failed replacements, spinal surgery and massive bone loss following trauma. Bone tissue can restore function to damaged, fractured or injured joints or can prevent limb amputation by replacing a cancerous or diseased bone. Bone and bone tissues to be transplanted are to fit specific dimensions of the recipient’s body.

A bone banking facility is functioning since 1999 at the Department of Orthopaedics at the All India Institute of Medical Sciences (AIIMS), New Delhi.

However, India’s first exclusive bone bank was inaugurated on 1st July 2005 at the Department of Orthopaedic Surgery in the Government General Hospital at Chennai.

Though bone tissue transplantation in India has not taken off yet, the above developments have set the stage for the development of bone transplantation in the country.

Bone Tissue Donation - A Selective Historical Timeline

6th Cent. B.C.: Sushruta– the world’s first surgeon who lived in India – described rhinoplasty (plastic surgery of the nose) in the first book of his medical treatise Sushruta Samhita

270 A.D.: Saints Cosmas and Damian – twin saints from Arabia around 270 A.D. – were famous for the legend where they miraculously grafted a leg from a recently deceased Ethiopian to replace a Roman patient's ulcerated leg. This has been the subject of many paintings and illuminations.

1682: A Russian nobleman’s who injured his skull and scalp in battle, was patched with a bit of bone taken from the skull of a dog. Records of this instance are found with the Russian church.

1878: The first successful bone transplant took place to fill a gap in the bone.

1880: Scottish surgeon William MacEwen used homogenous bone in the fresh state and reported success with its transplantation in Glasgow in a 3 year old child. This success is estimated among medical world to have laid the foundation for modern day bone transplantation surgery.

1908: Dr. Erich Lexer of Germany reported performing the first knee-joint transplant (from a cadaver). He claimed 25 serial bone transplant surgeries.

1914: Several attempts at bone replacement surgeries were made on soldiers injured during the World War I.

1935-1937: New York doctors. L. F. Bush and Philip D. Wilson successfully preserved homogenous bone grafts in a “bone bank” by refrigeration in sterile jars, at a temperature of between 10 and 20 degrees below zero centigrade, as the method of preservation, successfully avoiding any infection.

1948: Dr. Myron O. Henry used bones donated by the patient’s parents for a transplantation surgery.

1952: Czechoslovakian Dr. Rudolph Klen founded the first Tissue Bank in Europe. Tissues including bone tissues were banked here.

1978: Development in the field of bone transplantation science gave rise to three distinct specialties viz. replacements, transplantation techniques and transplantation products.

1990-2005 31 bone banks in the European Union and 30 bone banks in the USA were established, making the practice of bone donation prevalent.

Wanted Bone Tissue Donors - Why?

1. Patients with massive bone loss as a result of trauma, fracture non-unions, or bone tumours, who face possible amputation or expensive surgery involving the use of metallic prosthesis1, are provided with a relatively inexpensive option in bone transplant, thus saving the affected limb and prevent handicap. For instance, bone loss (occurring while treating spinal injuries or during hip replacement surgeries) and tumour gaps may be treatable with transplantation.

2. Though it is possible to use bones from the patient himself (autograft), it may not always be feasible, given the overall condition of the patient. Besides, use of bone tissue from one’s own body could make the operations riskier, costlier, and more painful and require longer recovery time. Bone tissue donors become the only option in such cases (allograft).

3. At times, the bone received by way of transplant may be incompatible with the patient’s anatomy in terms of specifications of shape, size or fitting. In such cases, doctors may have to ‘customize’ or ‘mill’ the donors’ bone as per the specification required for the patient. However, it is only after being transplanted (or grafted) with the donor’s bone, that the patient’s body adapts the donor bone. The donor bone stimulates the recipient’s cells to begin producing the new bone. This process is called ‘creeping substitution’ and occurs over many years.

4. Transplanting bone from a bone bank gives practically unlimited quantity of the bone for the reconstructive surgery with fewer incisions and lesser pain. Bone grafts shorten the recovery time for many orthopaedic procedures.

Screening before Bone Donation

1. Blood tests are carried out and all bone tissue donated are tested for infectious diseases that could be transmitted through donated parts.

2. The following ailments are contraindications for bone donation i.e. persons with the following conditions cannot make a bone donation.
a. Persons afflicted with AIDS and HIV
b. Active infection with the Hepatitis B or C virus or unexplained jaundice
c. Male donors who have had oral sex or anal sex with another male. (even if they had used the condom or any other barrier contraceptive)
d. Female donors who have had sex with men who have had sex with men
e. Those who have had sex for drugs or money – this is in order to rule out the possibility of any disease in the sexual partner of the prospective donor
f. Persons with malignancies
g. Diseases of bone and connective tissue disorders such as rheumatoid arthritis
h. Those who have been on steroids in order to increase weight (e.g. use of human derived pituitary growth hormone). Those who have initially been on steroid therapy, but have not been reviewed or re-examined by a doctor

Bone Donor Criteria

1. People in the age 15 to 50 years may donate long or large musculoskeletal parts.

2. No age limits are prescribed for donations of soft tissue like cartilages, ligaments and tendons. This is left to the discretion of the doctors based on age-related clinical research and other medical criteria.

3. Bone donation is possible both from living and dead donors. It is not necessary that a deceased donor is brain dead. For bone donation – as with eyes, skin and other tissues – both brain death and cardiac death are acceptable.

To Donate Bone Tissues, Contact...

Government General Hospital
Park Town (opp. Central Railway Station)
Chennai – 600 003

Telephone: 91- 44 - 5587 1159


Man cannot remake himself without suffering, for he is both the marble and the sculptor.”

Alexis Carrel (1873-1944), French Surgeon