Validating a Low Dose Gamma Irradiation Process for Sterilizing Allografts Using ISO 11137 Method 2B

This paper describes the validation of an allograft sterilization method specifically designed for the processing methods used at AlloSource in Centennial, CO. The methods used for this validation followed ISO Standard 11137, Method 2B. Three hundred allografts, collected from three defined production batches were dosed using a series of five incremental doses, beginning at 1 kGy and increasing by 1 kGy until 5 kGy was achieved. Following sterilization dosing, each allograft test article was analyzed using a sterility test to identify any viable microorganisms. The number of positive sterility samples was used to calculate the verification dose (1.27 kGy), which was then verified by an additional batch of 100 allografts. The results from this validation indicate that sterility (10⁻⁶ SAL) on human allograft tissue using gamma ⁶⁰Co radiation can be achieved when a dose of at least 9.2 kGy is employed.     

Validation of 15 kGy as a radiation sterilisation dose for bone allografts manufactured at the Queensland Bone Bank: application of the VD<Subscript>max</Subscript> 15 method

Background ISO 11137-2006 (ISO 11137-2a 2006) provides a VD_max 15 method for substantiation of 15 kGy as radiation sterilisation dose (RSD) for health care products with a relatively low sample requirement. Moreover, the method is also valid for products in which the bioburden level is less than or equal to 1.5. In the literature, the bioburden level of processed bone allografts is extremely low. Similarly, the Queensland Bone Bank (QBB) usually recovers no viable organisms from processed bone allografts. Because bone allografts are treated as a type of health care product, the aim of this research was to substantiate 15 kGy as a RSD for frozen bone allografts at the QBB using method VD_max 15—ISO 11137-2: 2006 (ISO 11137-2e, Procedure for method VD_max 15 for multiple production batches. Sterilisation of health care products – radiation – part 2: establishing the sterilisation dose, 2006; ISO 11137-2f, Procedure for method VD_max 15 for a single production batch. Sterilisation of health care products – radiation – part 2: establishing the sterilisation dose, 2006). Materials 30 femoral heads, 40 milled bone allografts and 40 structural bone allografts manufactured according to QBB standard operating procedures were used. Method Estimated bioburdens for each bone allograft group were used to calculate the verification doses. Next, 10 samples per group were irradiated at the verification dose, sterility was tested and the number of positive tests of sterility recorded. If the number of positive samples was no more than 1, from the 10 tests carried out in each group, the verification was accepted and 15 kGy was substantiated as RSD for those bone allografts. Results The bioburdens in all three groups were 0, and therefore the verification doses were 0 kGy. Sterility tests of femoral heads and milled bones were all negative (no contamination), and there was one positive test of sterility in the structural bone allograft. Accordingly, the verification was accepted. Conclusion Using the ISO validated protocol, VD_max 15, 15 kGy was substantiated as RSD for frozen bone allografts manufactured at the QBB.     

Sterilization of Allograft Bone: is 25 kGy the Gold Standard for Gamma Irradiation?

For several decades, a dose of 25 kGy of gamma irradiation has been recommended for terminal sterilization of medical products, including bone allografts. Practically, the application of a given gamma dose varies from tissue bank to tissue bank. While many banks use 25 kGy, some have adopted a higher dose, while some choose lower doses, and others do not use irradiation for terminal sterilization. A revolution in quality control in the tissue banking industry has occurred in line with development of quality assurance standards. These have resulted in significant reductions in the risk of contamination by microorganisms of final graft products. In light of these developments, there is sufficient rationale to re-establish a new standard dose, sufficient enough to sterilize allograft bone, while minimizing the adverse effects of gamma radiation on tissue properties. Using valid modifications, several authors have applied ISO standards to establish a radiation dose for bone allografts that is specific to systems employed in bone banking. These standards, and their verification, suggest that the actual dose could be significantly reduced from 25 kGy, while maintaining a valid sterility assurance level (SAL) of 10⁻⁶. The current paper reviews the methods that have been used to develop radiation doses for terminal sterilization of medical products, and the current trend for selection of a specific dose for tissue banks.     

Gamma radiation resistance of Bacillus anthracis spores

The aim of the presented study was determined the effectiveness of action the gamma radiation on water suspension B. anthracis spores. The irradiation was performed using a Cobalt 60 (Co 60) source, by using single and fractionary irradiation doses. In the investigations was used B. anthracis stain "Sterne" 34F2. The obtained results show, that gamma radiation effectively inactivates B. anthracis spores. On the efficiency of sterilization process influence the irradiation's method and the number of spores in 1 ml suspension. In the suspension 1.5 x 10(9) spore in 1 ml, sporicidal doses gamma radiation amount to 25.0 kGy (single dose) or 41.5 kGy (fractionary dose). The volume suspension about definite inoculum of spores, subjected working the gamma rays has not influence on sporicidal effectiveness of radiation sterilization.     

Indonesia: Statistical Sampling Technique in Validation of Radiation Sterilisation Dose of Biological Tissue

The aim of the work is to find the best solution for statistical sampling technique in validation of radiation sterilization dose (RSD) for biological tissues, according to ISO standard. As a model for sampling are biological tissues retrieved from one cadaver donor which consist of frozen bone grafts (18 packets), lyophilized allografts (68 packets) and demineralized bone powder grafts (40 packets). The size and type of products vary from long bones, cancellous chips to bone powders, tendons and facia lata, that make the number of bioburden per product could not be treated equally. Frozen samples could not be considered as the same production batch with lyophilized samples, because of different processing and irradiation temperature. The minimum number of uniformed samples needed for validation per production batch size, according to ISO 13409, is from 20 to 79 and 20 of them will be used for the test sample size, i.e. 10 for bio-burden determination and the remaining 10 for verification dose. Based on the number of uniformed grafts, statistical sampling can be carried out on lyophilized and demineralized bone grafts, but not on frozen bone grafts. Bioburden determinations were carried out and validated according to ISO 11737-1. Results of average bioburden determination (cfu/per packet), using sample item portion (SIP) = 1, are 5 cfu/packet for lyophilized bone grafts and 4 cfu/packet for demineralized bone powder grafts. Verification doses obtained were 2.40 kGy for lyophilized grafts and 2.24 kGy for demineralized bone powder grafts. The results of verification dose were accepted and the RSD of 25 kGy is substantiated It can be concluded that a statistical sampling technique can be applied if all the grafts produced in the same process such as lyophilized, demineralized as well as frozen are assumed to be in one production batch regardless of sample uniformity such as size, type and weight; for this ISO 13409 can be applied for the validation of RSD.     

Validation of Radiation Sterilization Dose for Lyophilized Amnion and Bone Grafts

A limited number of grafts produced in one batch is the main constrain to validate radiation sterilization dose of amnion and bone grafts according to ISO standard. The validation experiments done were according to ISO 13409 with a slight modification in sampling method. The experiments were carried out three times by using 20 samples each, 10 for bio-burden enumeration and 10 for sterility test at verification dose. The average bio-burden with sample item portion (SIP) = 1 for amnion membranes were 98, 50 and 69 cfu respectively and 0 cfu for bone grafts. Verification dose experiments, were done at doses of 2.90kGy for bone grafts and 5.13kGy for amnion grafts and the results of sterility tests showed that amnion grafts got one positive and bone grafts got 0 positive. The results met the requirements of ISO 13409 so that the radiation sterilization dose, at sterility assurance level of 10^-6 was 25kGy for both amnion and bone grafts. Viral contamination was excluded in this experiment.     

Substantiation of 25 kGy radiation sterilization dose for banked air dried amniotic membrane and evaluation of personnel skill in influencing finished product bioburden

Preparation of amniotic membrane (AM) by air drying method followed by radiation sterilization is simple and valuable approach; sterility and quality of the final AM product are depending on the quality management system at the tissue bank. Validation and substantiation of radiation sterilization dose (RSD) for tissue allografts is an essential step for the development and validation of the standard operating procedures (SOP). Application of SOP is perfectly relying on trained staff. Skills differences among personnel involved in AM preparation could have an effect on microbiological quality of the finished product and subsequently on the RSD required. AM were processed by four different couples of the tissue bank technicians. The AM grafts were randomly selected and subjected to bioburden test to validate and substantiate the 25 kGy RSD. Bioburden test for AM grafts were also useful to evaluate the skill of the tissue bank technicians and thus, to validate the current SOP for air dried AM. Moreover, the effect of placental source on bioburden counts on AM grafts was assessed. Substantiation of the 25 kGy RSD at a sterility assurance level of 10^?1, and sample item portion = 1, was carried out using Method VD _max ²⁵ of the International Organization for Standardization, document no. 11137-2 (ISO in Sterilization of healthcare products—radiation—part 2: establishing the sterilization dose, Method VDmax—substantiation of 25 kGy or 15 kGy as the sterilization dose, International Standard Organization, 2006). The results showed that there were no significant differences in the bioburdens of the four batches (α = 1 %), this means no significant differences in the skill of the four couples of the tissue bank technicians in terms of their ability to process AM according to the air dried AM SOP. The 25 kGy RSD was validated and substantiated as a valid sterilization dose for the AM prepared with the current established SOP at the Biotechnology Research Center experimental tissue bank. The donor’s type of delivery, normal or caesarean, showed no significant effect on the levels of microbial counts on the tested AMs (α = 1 %).     

Sterilization of allograft bone: effects of gamma irradiation on allograft biology and biomechanics

Gamma irradiation from Cobalt 60 sources has been used to terminally sterilize bone allografts for many years. Gamma radiation adversely affects the mechanical and biological properties of bone allografts by degrading the collagen in bone matrix. Specifically, gamma rays split polypeptide chains. In wet specimens irradiation causes release of free radicals via radiolysis of water molecules that induces cross-linking reactions in collagen molecules. These effects are dose dependent and give rise to a dose-dependent decrease in mechanical properties of allograft bone when gamma dose is increased above 25 kGy for cortical bone or 60 kGy for cancellous bone. But at doses between 0 and 25 kGy (standard dose), a clear relationship between gamma dose and mechanical properties has yet to be established. In addition, the effects of gamma radiation on graft remodelling have not been intensively investigated. There is evidence that the activity of osteoclasts is reduced when they are cultured onto irradiated bone slices, that peroxidation of marrow fat increases apoptosis of osteoblasts; and that bacterial products remain after irradiation and induce inflammatory bone resorption following macrophage activation. These effects need considerably more investigation to establish their relevance to clinical outcomes. International consensus on an optimum dose of radiation has not been achieved due to a wide range of confounding variables and individual decisions by tissue banks. This has resulted in the application of doses ranging from 15 to 35 kGy. Here, we provide a critical review on the effects of gamma irradiation on the mechanical and biological properties of allograft bone.     

Validation and Substantiation of 25 kGy as Sterilization Dose for Lyophilized Human Amnion Membrane

The validation and substantiation of sterilization dose for lyophilized human amnion membrane by gamma irradiation delivered by Co⁶⁰ source were investigated. The validation experiments were conducted according to ISO 13409 method B. A total of 120 human amnion membranes were collected. Of these, 10 membranes were used for estimation of bioburden and 20 membranes were used for the individual sterility test at verification dose. The average bioburden per product unit with sample item portion (SIP = 1) for lyophilized human amnion membrane was 572 cfu. The verification dose experiments were done at dose of 8.1 kGy and the results of sterility tests showed that human amnion membrane got one positive. Consequently, the sterilization dose of 25 kGy was confirmed and substantiated.     

ESR signals of NADH and NADPH under illumination

ESR method was applied to investigate the formation of NADH and NADPH free radicals. It was shown that under the action of light (340 nm) in water and other solutions of these compounds a reaction occurred resulting in the formation of free radicals having the typical ESR spectrum. The analysis of the temperature dependence showed the light-induced ESR signals to be registered at −30°C to −120°C, the most intensive ones being observed at −50°C. It was concluded that the observed ESR signals belonged to the products of one-electron oxidation of the coenzymes-free radicals NAD^. and NADP^..     

Free radicals properties of gamma-irradiated penicillin-derived antibiotics: piperacillin,ampicillin, and crystalline penicillin

The aim of this work was to determine the concentrations and properties of free radicals in piperacillin, ampicillin, and crystalline penicillin after gamma irradiation. The radicals were studied by electron paramagnetic resonance (EPR) spectroscopy using an X-band spectrometer (9.3 GHz). Gamma irradiation was performed at a dose of 25 kGy. One- and two-exponential functions were fitted to the experimental data, in order to assess the influence of the antibiotics’ storage time on the measured EPR lines. After gamma irradiation, complex EPR lines were recorded confirming the presence of a large number of free radicals formed during the irradiation. For all tested antibiotics, concentrations of free radicals and parameters of EPR spectra changed with storage time. The results obtained demonstrate that concentration of free radicals and other spectroscopic parameters can be used to select the optimal parameters of radiation sterilization of β-lactam antibiotics. The most important parameters are the constants τ (τ _1(A),(I) and τ _2(A),(I)) and K (K _0(A),(I), K _1(A),(I), K _2(A),(I)) of the exponential functions that describe free radicals decay during samples storage.     

The rationale and a computer evaluation of a gamma irradiation sterilization dose determination method for medical devices using a substerilization incremental dose sterility test protocol

The experimental procedure described is designed to allow calculation of the radiation sterilization dose for medical devices to any desired standard of sterility assurance. The procedure makes use of the results of a series of sterility tests on device samples exposed to doses of radiation from 0.2 to 1.8 Mrad in 0.2 Mrad increments. From the sterility test data a 10^-2 sterility level dose is determined. A formula is described that allows a value called DS Mrad to be calculated. This is an estimate of the effective radiation resistance of the heterogeneous microbial population remaining in the tail portion of the inactivation curve at the 10^-2 dose and above. DS Mrad is used as a D ₁₀ value and is applied, in conjunction with the 10^-2 sterility level dose, to an extrapolation factor to estimate a sufficient radiation sterilization dose. A computer simulation of the substerilization process has been carried out. This has allowed an extensive evaluation of the procedure, and the sterilization dose obtained from calculation to be compared with the actual dose required. Good agreement was obtained with most microbial populations examined, but examples of both overdosing and underdosing were found with microbial populations containing a proportion of organisms displaying pronounced shoulder inactivation kinetics. The method allows the radiation sterilization dose to be derived from the natural resistance of the microbial population to gamma sterilization.     

The radiation resistance of ascospores and sclerotia of Pyronema domesticum

The Food and Drug Administration has become aware of several instances where supposedly sterile medical surgical products made of Chinese cotton have been found to contain viable Pyronema domesticum. The aim of this research was to determine the gamma and electron beam radiation resistance values for the two dormant phases (ascospores and sclerotia) of P. domesticum. The resistance values were obtained by developing a standardized system to cultivate, purify, and harvest biological indicators containing sclerotia or ascospores. Ascospores were more resistant to radiation than sclerotia. The D ₁₀ values for sclerotia were 0.79 and 1.09 kGy for strains 32030 and 14881, respectively. The resistance value for wild type ascospores was 2.83 kGy. The current standard for assuring radiation sterilization of medical devices is ISO 11137. This standard was developed to address the propensity for highly radiation-resistant organisms such as P. domesticum. Prior to the standard, biological indicators such as Bacillus pumilus, having a nominal D ₁₀ value or 1.7 kGy, were used to determine the sterility of many medical devices. Journal of Industrial Microbiology & Biotechnology (2002) 29, 51–54 doi:10.1038/sj.jim.7000267 Received 09 October 2001/ Accepted in revised form 08 April 2002     

Chemical reactivity of the carbon-centered free radicals and ferrous iron in coals: Role of bioavailable Fe2+ in coal workers' pneumoconiosis

Striking differences in the prevalence of coal workers' pneumoconiosis (CWP) exist between different coal mine regions. The major factors responsible for the observed regional differences in CWP have not yet been identified. In the present study, chemical reactivity of the carbon-centered free radicals in coals and lung tissues, as well as ferrous iron in the coals, were studied by ESR techniques. The ESR spectra clearly demonstrated the presence of at least two types of carbon-centered free radical species, which might respectively attribute to the macromolecular phase and the molecular phase of coal. Grinding produced free radicals in coals. Exposure of freshly ground coal to air for 28 h induced a slight increase of free radicals for most of the coals, and a slight decrease after 4 months' exposure. The lung tissue samples of coal workers deceased of CWP showed similar ESR spectra as coal samples, and these radicals were highly stable in the lung. After incubation of coals with glutathione, hydrogen peroxide, sodium formate or oxygen, the coal sample from the Gardanne mine which has never induced CWP, and thus is the least hazardous coal, showed the most significant change in the carbon-centered free radical concentration. No significant changes were observed among other coals reported to induce CWP. On the other hand, we found that the coals released different amounts of Fe²⁺ in an acidic medium. Interestingly, the prevalence of CWP correlates positively with the released Fe²⁺ content in these coals and with the amount of oxygen radicals produced by the interaction of Fe²⁺ with O₂ in the acidified coal filtrates. Our studies indicate that the carbon-centered free radicals may not be biologically relevant to coal dust-induced pneumoconiosis, whereas the acid soluble Fe²⁺, which may be dissolved in the phagolysosomes of macrophages, can then lead to Fe²⁺-induced oxidative stress and eventual CWP development.     

Radiation Resistance of the Microflora Associated with Amniotic Membranes

Summary Amniotic membrane is widely used in the treatment of burn wounds and ulcers of various etiology. As it comes into contact with open wounds, it needs to be perfectly sterile to avoid the transmission of any disease. Accordingly, amniotic membrane needs to bear a high sterility assurance level (SAL). Conventionally, a radiation dose of 25 kGy is the generally accepted dose for sterilization. But to keep intact the biomechanical and other properties, it is sometimes proposed to use a lower dose without compromising an SAL of 10⁻⁶. The initial microbial contamination level and the radiation resistance of the contaminants determine the dose required for sterilization. The microbial species associated with the amniotic membrane from about 70 different batches were isolated. Twenty-two representative bacterial isolates were characterized and tested for survival in an incremental series of radiation doses from 0.5 to 5.0 kGy. The radiation decimal reduction dose (D₁₀) values for the strains were determined. Relatively higher D₁₀ values were recorded for the gram-positive isolates. The D₁₀ values of microbial isolates ranged from 0.16 to 1.3 kGy, and most resistant Bacillus strain had a D₁₀ value of 2.1 kGy. The radiation dose necessary to achieve an SAL of 10⁻⁶ was calculated based on the D₁₀values of the isolated strains. For a bioburden of 1000 Bacillus organism, the sterilization dose of 18.9 kGy is obtained. However, based on the experimental determination of D₁₀ of the radiation-resistant reference strain Bacillus pumilus, the adequate dose for radiation sterilization is found to be 19.8 kGy if bioburden level of 1000 is granted. The results substantiate that radiation dose of 25 kGy assures sterilization of amniotic membranes with bioburden level of 1000 colony forming units.     

Radiation effects on microcrystalline cellulose in 1-butyl-3-methylimidazolium chloride ionic liquid

The radiation processing of cellulose in ionic liquids (ILs) demands a comprehensive knowledge of radiation effects on cellulose in ILs. Herein, gamma radiation-induced degradation kinetics of microcrystalline cellulose (MCC) in 1-butyl-3-methylimidazolium chloride ([Bmim]Cl) was studied by viscometry. The intrinsic viscosity of MCC in [Bmim]Cl decreased slightly with increasing dose; while chemical structure and crystalline state of cellulose has no obvious change up to 300kGy. The radiation degradation rate constant (k) of MCC in [Bmim]Cl was 2.60×10(-7)/kGy, lower than that of solid cellulose, but higher than that in N-methylmorpholine-N-oxide (NMMO) solvent. Furthermore, k value decreased to 1.12×10(-7)/kGy in dimethyl sulfoxide (DMSO)/[Bmim]Cl system due to the free radicals scavenging of DMSO. The radicals generated during irradiation play main role in the radiation degradation of MCC in [Bmim]Cl. This work provides a new way to control the average molecular weight of cellulose by radiation-induced degradation of cellulose in ILs.     

Toxic Effects and Detection of Oxygen Free Radicals on Cultured Articular Chondrocytes Generated by Menadione

The aim of this work was to study the proliferation pathological perturbations of cultured chondrocytes in response to menadione, an oxygen free radicals producing drug. Rabbit articular chondrocytes in monolayer culture were treated with 10^-5, 1.5.M^-5 and 2.10^-5M of menadione during three days. A dose dependent decrease of the proliferative capacity was observed. Flow cytometry analysis revealed a perturbation of the cell cycle progression consisting in an accumulation of cells in the S and G2 + M phases. This growth perturbation was due to oxygen radicals production since a treatment with catalase suppressed these toxic effects. Furthermore, to identify oxygen derived radicals in the cellular suspension of cultures treated with menadione, we used a technique of spin-trapping coupled with electron spin resonance (ESR). The ESR signal corresponding to the DMPO hydroxyl radical adduct (DMPO-OH) has been detected. The spectra observation indicated the actual production of hydroxyl radical. However, superoxide anions have not been identified; this fact can be explained by the low reactivity of these anions with DMPO and by the decomposition of signal DMPO-OOH to DMPO-OH.     

Effect of titanium dioxide concentration on the survival of Pseudomonas stutzeri during irradiation with near ultraviolet light

Cells of Pseudomonas stutzeri in suspensions of TiO₂ ranging in concentration from 0.5 to 4.0 g l^-1 were irradiated with a blacklight blue u.v. source displaying peak emissivity at approximately 370 mm. Irradiation under these conditions is known to result in the generation of lethal free radicals. During irradiation the suspensions were agitated, using a specially modified laboratory shaker, to ensure efficient exposure of the TiO₂. A u.v. radiation dose of 175 kJ m^-2 resulted in cell fractional survival ranging from 5.5 times 10^-5, at the lowest TiO₂ concentration, to 1.0 times 10^-6, at the highest TiO₂ concentration. The advantages of contactors employing TiO₂ suspensions are briefly compared to immobilized TiO₂ systems.     

UV-induced free radicals in the skin detected by ESR spectroscopy and imaging using nitroxides

Reactive free radicals and reactive oxygen species (ROS) induced by ultraviolet irradiation in human skin are strongly involved in the occurrence of skin damages like aging and cancer. In the present work an ex vivo method for the detection of free radicals/ROS in human skin biopsies during UV irradiation is presented. This method is based on the Electron Spin Resonance (ESR) spectroscopy and imaging and uses the radical trapping properties of nitroxides. The nitroxides 2,2,6,6-Tetramethylpiperidine-1-oxyl (TEMPO), 3-Carbamoyl-2,2,5,5-tetramethylpyrrolidine-1-oxyl (PCM), and 3-Carboxy-2,2,5,5-tetramethylpyrrolidine-1-oxyl (PCA), were investigated for their applicability of trapping reactive free radicals and reactive oxygen species in skin during UV irradiation. As a result of the trapping process the nitroxides were reduced to the EPR silent hydroxylamins. The reduction rate of TEMPO was due to both the UV radiation and the enzymatic activity of the skin. The nitroxides PCM and PCA are sufficiently stable in the skin and are solely reduced by UV-generated free radicals/ROS. The nitroxide PCA was used for imaging the spatial distribution of UV-generated free radicals/ROS. As a result of the homogeneous distribution of PCA in the skin, it was possible to estimate the penetration of UVA and UVB irradiation: The UV irradiation decreased the PCA intensity corresponding to its irradiance and penetration into the skin. This reduction was shown to be caused mainly by UVA radiation (320-400 nm).     

The effect of substrate on the radiation resistance of yeasts isolated from sausage meat

J.-A, McCARTHY AND A.P. DAMOGLOU. 1996. The radiation resistance of a selection of yeasts isolated from sausages was assessed in phosphate-buffered saline and in sausage meat. The yeasts Candida zeylanoides, Debaryomyces hansenii and Trichosporon cutaneum exhibited sigmoidal survival curves in both substrates whilst the more sensitive Sporobolomyces roseus exhibited an exponential survival curve in buffer but a sigmoidal curve in meat. Irradiating C. zeylanoides, D. hansenii and T. cutaneum in sausage meat changed the shape of their survival curves to significantly alter the calculated parameters D _s (the dose in kGy that must be achieved before reduction in numbers occurs) and D ₁₀^sig(the dose in kGy required after the shoulder to achieve a 1 log cycle reduction in numbers). The D _s values were reduced while higher D ₁₀^sigvalues were obtained demonstrating that the sausage meat contributed a protective effect to these yeasts at higher irradiation doses. For the yeast S. roseus , similar numbers of survivors were recovered from both substrates at initial low irradiation doses (0–0.5 kGy) with the protective effect being demonstrated again at higher doses (> 2 kGy). These findings should be considered when defining a commercial process to reduce the numbers of yeasts in these products.