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Donor bone - can it be rejected?

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  • Donor bone - can it be rejected?

    Hello,
    My daughter's spinal fusion surgery is on Aug. 3rd. I am trying to think of questions to ask the surgeon. I understand that the surgeon uses bone from your own body or donor bone. My child has Quad Cerebral Palsy and had a very difficult time with breathing after her last surgery. I have read posts that say taking bone from the rib or hip is very painful and from the rib causes breathing difficulty. If the surgeon uses donor bone, can it be rejected by the body just like organs are sometimes rejected when transplanted into a person who need a new organ???
    What do you think is the best way to go?
    Thanks,
    Sue (Amanda's mom)

  • #2
    I think with cadaver bone there may be a slight chance the body might reject it. With bone morphogenetic protein (BMP) I am not sure. I think the fusion rate in children is generally high. It is an excellent question to ask your surgeon.

    I don't know your daughters age, size or proposed length of fusion, but when my son had surgery the bone was taken directly off the spine. His fusion is long, down to L4, and the bottom couple of inches of the scar is somewhat larger where the bone was taken from the lumbar vertebrae. I don't know if this procedure is an option only for larger/lower fusions. The good thing is my son did not experience any additional pain, it has never bothered him.

    I wish your daughter (and you!) a successful surgery and recovery.

    Renee

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    • #3
      Just read your other posts on Amanda. Your family has been through alot already....I will keep you in my prayers.

      Renee

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      • #4
        Renee,
        Amanda whole spine will be fused. The curve starts at the top and curves in a "C" at the bottom by the hips it is so twisted. It looks like her spine collaped. I had not heard that they can use her own bone from her spine. That is encouraging to know that your son did not experience more pain by the surgeon doing that.
        Amanda is 13. She has always had scoliosis, but after a growth spurt 2 years ago the scoliosis wrosened to wheere we are now.
        Do you know who much more time it took during the surgery to harvest the bone? Amanda does not do well under anesthia for long periods of time. How long was your son's surgery?
        Thank you,
        Sue (Amanda's mom)

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        • #5
          Hi Sue,

          I don't know how much actual time it took to harvest the bone itself. The advantage was, they were operating on that area anyway, and didn't have to make an additional incision. The whole surgery took about four hours. He was walked into the O.R. around 8am and it was around noon when they called the waiting room to let us know surgery was over. We went in to talk to dr. by 12:30pm.

          Renee

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          • #6
            Hi there
            I don't think rejection is an issue because the donor bone is treated - I think they freeze it - to destroy surface antigens which are what the body would react to. Certainly it was never suggested to us that there was the slightest chance of needing immunosuppressive, anti-rejection drugs.
            Also, I know they don't need to match blood types with the donor because the donated tissue is essentially an inert substance by the time it gets to the recipient.
            Hope this helps
            Lorrie

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            • #7
              Hi again

              How much of Amanda's back will need to be fused? With Genevieve our surgeon said they would not be able to take bone from her hip because she was being fused right down to her pelvis and they couldn't take bone from her hip as well.
              He was only going to use her own bone for the fusion if they had had to go in from the front as well as the back and therefore remove a rib. Fortunately she 'only' had to be operated on from the back so we only had donor bone.

              Lorrie

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              • #8
                Hello Lorrie,

                It is getting close to Amanda's surgery. (August 3, 2006). She has a day of pre-op appts. July 6, 2006.
                Amanda is going to have her entire spine fused. I can tell every week that the curve is getting worse. She seems to be having breathing difficultyand is not sleeping well.
                Her pedi found a heart murmur a month ago. Amanda had a echocardiogram and she has been diagnosised with Mitral Valve Prolapse. The pedi said Amanda can still have her surgery, but she will have to have pre-op antiibioctics.
                I am praying Amanda will not have breathing problems after surgery.

                Sue

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                • #9
                  Lorrie,
                  I did met Megan's mom. We live 30 min. from each other. She let me ask her questions and was very kind. We will be getting our girls together before Amanda's surgery.
                  Sue

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                  • #10
                    Hi Sue
                    I'm so glad tohear you met Megan's mum - it's a real coincidence that you two should live so close to each other!
                    It's so scary when they keep finding more things for you to worry about but it's just as well that they found Amanda's heart problem before surgery. At least now they can allow for it. I will also pray that she comes through OK. Good luck for the pre-op.
                    Best Wishes and a big hug
                    Lorrie

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                    • #11
                      Amanda saw the surgeon yesterday. He was very nice and ansewed all my questions. He will use donor bone. He said the bone is treated and they will also be using man made (I think it is the BMP). The body does not reject it. Amanda will be fued from T4 all the way down to her hips. He said she will have great results (nice straight spne) I'm excited about that. I hate that she has to go though another surgery, wishing she was 1 yr post-op. Surgery will be 6-7 hours long. They will get respitory therapy right on getting her to cough. Dr. Leake is suppose to be one of the best spinal fusion surgeons. I am so please he wil be doing it.
                      Sue

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                      • #12
                        Hi, I read your post and I can totally relate to your situation. I have a 10 year old son with spastic quad CP. He has a 70 degree thoracic curve pushing on his left lung. He has respiratory issues as well. Pauses in his breathing all the time and is on nightime oxygen now and sometimes needs it depending on his positioning. He is having spinal fusion on July 24 and this Wednesday has a few preop appts. I am worried about the respiratory issues with this surgery. My son has a history of atelectasis and pneumonia after surgeries. Although he did very well a month ago with hydrocele surgery but this was a much smaller surgery in comparision to the spine fusion surgery. It sounds to me you are doing the right things by asking alot of questions and making sure there is a plan of respiratory care in place post op which is so important. You want to make sure they are doing everything they can on their end. I have done the same for my son and I believe it made all the difference on his last surgery. They were proactive and not waiting for the pneumonia to set in. I also informed the critical care docs that he would be back in a month for spine fusion and they are aware of the situation. I know I've been back and forth on this decision whether or not to go through with it or not. The reality is there isn't much of a choice. The respiratory problems will get worse and eventually cardiac problems as well. You want to do it while your child is in good shape and is healthy. My son is having posterior fusion but will be fused down to the pelvis. I think you mentioned your daughter is having the same. Although I don't know if it is anterior, posterior or anterior/posterior. I believe he will be having donor bone as well. My son is osteopenic plus I don't want them taking bone from his hips. I think it is just more pain and makes the surgery a little bit longer.

                        I know I have talked to a lot of parents both on this forum and here at home and all of the kids have gotten through this surgery. It may be a bit bumpy but once it is all said and done their parents are glad they did it and would say if there was one surgery that made a big improvement/difference it was this one. I've seen some of these children and they look so good. Their spines are straight and honestly if I didn't know they had spinal fusion I wouldn't know it. I think we just have to try to keep optimistic and remember that this too shall pass.
                        Linda
                        Mom to Hunter (10 yrs old), status post posterior spinal fusion T1-sacrum 7/24/06 w/spastic quad CP

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