Country's lone cadaveric bone bank a non-starter even after 18 yrs of its inception

All seems not well with the country's only full-fledged cadaveric bone bank. Lack of awareness and misconceptions about such donations have led to the facility remaining almost a non-starter even after 18 years of its inception.
The dismal figures at the bone bank at the AIIMS say it all. The bank, which was set up in 1999, has received just 24 cadaver donations so far. More so, there has been no donation in the last two years.
"Lack of knowledge coupled with misconceptions and religious sentiments are major problem. Even after being set up in 1999, the first bone donation was not until 2001," Dr Rajesh Malhotra, the chief of AIIMS Trauma Centre and who had started the bank, said.

People think that taking out bones will mutilate and disfigure the body and the limbs will dangle, he said, adding "Well, it does not."
Once the bones are taken out, the body is reconstructed and shape and structure of the limbs are restored by putting wooden sticks and stuffing it up with cotton and wool. Even knee caps are made with cotton and wool.
"So, after taking out the bones, which usually takes 10 minutes, we spend the next 30 minutes on stitching up the body so that aesthetically it looks good and the dignity of the donor is maintained.

"All that the relatives of the deceased will be able to see is a stitch, like that is visible after surgery," Malhotra explained.

The cotton wool also absorbs any fluids oozing out and the body is not left in a puddle of blood after the procedure.
The donated bones can be used for various purposes. They can replace a lost segment of bone due to cancer, infection or injury. Also it can be used to fill up cavities or holes left by major cancer surgeries, the doctor said.
Bones from cadavers have to be retrieved within 12 hours. If a body is refrigerated, then the time frame extends up to 38 hours. They are then tested for HIV, hepatitis or any other infection.

If this procedure is followed and the bones then stored at -70 degrees, these can be preserved for around five years, Malhotra said.
Thousands of cancer and trauma patients need bone transplants in India every year, while only 35 per cent of them get these.
Bones can be donated by people even when they are alive, Malhotra said.
"Suppose, a child has deformity of spine and undergoes a surgery to correct it. During this, the ribs which are taken out can be conserved and used in another person."
Also in hip replacements, femur bone is taken out which can also be used to fill up cavities or give attachment to the socket, Malhotra said.

"Even in such cases, we test the blood for infections like HIV, Hepatitis and repeat these tests after six months," he said.
While several countries have set up bone banks to cater the increasing demands, India has only few bone banks out of which AIIMS, New Delhi has one of the oldest and the only cadaveric one.