Bone biopsy as a screening technique for bone bank allograft donation.

The objective of the study was to investigate occult abnormalities in bone bank allograft with the use of histomorphometry that may otherwise go unidentified with current screening techniques. This was a prospective pathology review in which 40 transcortical trephine bone biopsies were taken from the iliac crest of bone donors and examined by light microscopy and semiautomated histomorphometry. Current routine screening techniques for allograft bone donors include history, serology, and culture. Additional screening for unsuspected pathology and for parameters related to metabolic bone disease may predict the effectiveness of the donor bone. Light-microscopic findings showed 1 case suspicious for chronic myeloproliferative disorder, which had otherwise not been detected by standard screening techniques. On histomorphometric analysis, 3 specimens showed severe osteoporosis. In conclusion, iliac crest bone biopsy may need to be considered as an adjunct in screening for both unsuspected hematological disease and metabolic bone disease.