Massive deep-frozen bone allografts : contamination, immunogenicity and clinical use
Hele tekst
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(5) ññ$IBQUFSñ. . 'PSBOZPOFEPOPS UIFQSPQPSUJPOPGHSBGUTXIJDIXFSFDPOUBNJOBUFE XJUINJDSPPSHBOJTNTPGMPXQBUIPHFOJDJUZWBSJFEGSPNïǷUPðïïǷBOE XJUINJDSPPSHBOJTNTPGIJHIQBUIPHFOJDJUZQSJNBSJMZGSPNïǷUPUòïǷ 'JHð "TJOHMFPSHBOJTNXBTDVMUVSFEGSPNøóñHSBGUTBOENPSFUIBOPOF GSPNððóɨFNPTUGSFRVFOUMZDVMUVSFEPSHBOJTNTXBTDPBHVMBTFOFHB UJWFTUBQIZMPDPDDVT ÷ñǷ 0GPSHBOJTNTPGIJHIQBUIPHFOJDJUZUIFNPTU GSFRVFOUMZTFFOXFSF4USFQUPDPDDVTTQFDJFT 5BCMF* . UIFDBVTFPGEFBUI QSFDFEJOHPSHBOIFBSUWBMWFQSPDVSFNFOUBOECPOF QSPDVSFNFOUEVSBUJPOXFSFOPUBTTPDJBUFEXJUIJODSFBTFESJTLPGDPOUBNJ OBUJPOXJUIPSHBOJTNTPGMPXQBUIPHFOJDJUZ 5BCMF** . "LOOD CONTAMINATION #MPPEGPSDVMUVSFXBTPCUBJOFEGSPNð÷õPGUIFñïïEPOPST4FWFOUFFODVM UVSFTDPOUBJOFEPSHBOJTNTPGMPXQBUIPHFOJDJUZPSJHJOBUJOHGSPNUIFTLJO CVUJEFOUJDBMPSHBOJTNTXFSFOPUDVMUVSFEGSPNUIFJSBMMPHSBGUT8FDPO TJEFSFEUIFTFDVMUVSFTUPCFGBMTFMZQPTJUJWFCFDBVTFPGFYUFSOBMDPOUBNJOB UJPOEVFUPOFFEMFQFSGPSBUJPO5XFOUZTJYCMPPEDVMUVSFTXFSFUSVMZQPTJ UJWFɨFQSFEPNJOBOUPSHBOJTNTDVMUVSFEXFSF 4USFQUPDPDDVTTQFDJFT 0REDISPOSING FACTORS FOR GRAFT CONTAMINATION .VMUJQMFMPHJTUJDSFHSFTTJPOBOBMZTJTTIPXFEUIBUTFWFSBMSJTLGBDUPSTXFSF TJNVMUBOFPVTMZTJHOJmDBOU'VSUIFSNPSF UIFDPSSFMBUJPOPGHSBGUTXJUIJO POFEPOPS SBOEPNFĊFDU XBTIJHIMZTJHOJmDBOU Qïïïð 5PBDDPVOU GPSUIJTDPSSFMBUJPOXIFOBTTFTTJOHUIFTJHOJmDBODFPGUIFSJTLGBDUPST B SBOEPNFĊFDUUFSNXBTBEEFEUPUIFMPHJTUJDSFHSFTTJPONPEFM*GUIJTDPS SFMBUJPOJTOPUUBLFOJOUPBDDPVOUVOXBSSBOUFEMFWFMTPGTJHOJmDBODFNBZ BSJTF'PSUIFBOBMZTJTBEJTUJODUJPOXBTNBEFCFUXFFONJDSPPSHBOJTNTPG IJHIQBUIPHFOJDJUZBOEUIPTFPGMPXQBUIPHFOJDJUZ .JDSPPSHBOJTNTPGMPXQBUIPHFOJDJUZ ɨFOVNCFSPGTUBĊNFNCFSTQFSGPSNJOHUIFQSPDVSFNFOU UIFUZQFPG HSBGUBOEUIFUJNFTJODFEFBUIXFSFSJTLGBDUPSTBTTPDJBUFEXJUIDPOUBN JOBUJPO 5BCMF** &BDITUBĊNFNCFSBEEFEUPUIFQSPDVSFNFOUUFBN JODSFBTFEUIFSJTLPGDPOUBNJOBUJPOCZBGBDUPSPGðõ Qïïïð 'PSFBDI IPVSJODSFBTFCFUXFFOUIFUJNFPGEFBUIBOEQSPDVSFNFOU UIFSJTLPG DPOUBNJOBUJPOEFDSFBTFECZBGBDUPSPGïøò Qïïïñ ɨFUZQFPGHSBGU BMTPJOnVFODFEUIFSJTLPGDPOUBNJOBUJPO Qïïïó ɨFDPOUBNJOBUJPO SBUFXBTMPXGPSUIFSBEJJBOEIJHIGPSUIF"DIJMMFTUFOEPOT5SBVNBBT. ñò. 4ABLE )) 4HE EFFECT OF VARIOUS FACTORS ON THE RELATIVE RISK OF GRAFT CONTAMINATION WITH LOW PATHOGENIC ORGANISMS SEE 4ABLE ) ESTIMATED BY ODDS RATIOS $POUBNJOBUJPO PG(SBGUT 'BDUPST 5SBVNBUJDDBVTFPGEFBUI /P OǺǾȁ. :FT Oǽǻ. 1SFDFEJOHQSPDVSFNFOU /P OǺǹǹ. 0SHBO OǾȁ. )FBSUWBMWF Oǽǻ. 5JNFTJODFEFBUI 1FSǺISJODSFBTF 5FBNNFNCFST Ǽ OǾ. ǽ OȂǹ. Ǿ OȂǹ. ǿ OǺǾ. 1SPDVSFNFOUEVSBUJPO 1FSǺISJODSFBTF 5ZQFPGHSBGUT )VNFSVT 3BEJVT 'FNVS 5JCJB 'JCVMB 1FMWJT "DIJMMFTUFOEPO #MPPEDPOUBNJOBUJPOq /P OǺǿǹ. :FT Oǻǿ. "OUJCJPUJDSJOTF /P OǾǹ. :FT OǺǾǹ. /P. :FT. -PHJTUJD3FHSFTTJPOp 0EET3BUJP. ôðƧ$*. ȀǿȀ ǺȀǿ. ȁǹǻ ǺȂȀ. Ǻ. ǺǼ. ǽȂǹ ǻǿǼ ǺȂǹ. ǽǿǺ Ǽǻǿ ǻǺǻ. Ǻ. ǹȂ ǺǾ. ǹǾUPǺǾ ǹȂUPǼǺ. ǹȂǼ. ǹȂUPǺǹ. QWBMVF ǹǼȂ. ǹȀUPǻǻ ǹǻȀ. ǹǹǹǻ ǹǹǹǺ Ǽǽ ǽǾǿ ǼȁȀ ǿǿ. ǺǼ ǼȂǺ ǽȁǼ ǺǺǻ. Ǻ. Ǻǿ ǻǽ ǼȀ. ǺǻUPǻǾ. ǹǽǻ ǺǼ. ǹȀUPǻǾ ǹǹǹǽ. ȁǽ Ǻȁ Ǽǻǹ ǺȂǹ ǺǾǹ ǿǾ ȁȀ. ȂȀ ǿ ǼǺǼ ǻǹǽ Ǻǻǿ ȀǼ ǺǽǾ. Ǻ. ǹǽ ǹȂ Ǻǹ ǹȁ ǺǺ Ǻǿ. ǹǺUPǺǻ ǹǿUPǺǽ ǹǿUPǺǿ ǹǾUPǺǻ ǹǿUPǻǹ ǺǼUPǼǽ. ȀǾǾ ǺǻǺ. ȁǺǽ ǺǺǻ. Ǻ. ǹȂ. ǹǿUPǺǿ. ǺȂǺ ȀǾǻ. ǻǿǹ ȀǼȂ. Ǻ. ǹǾ. ǹǻȂ ǹȁǺ ǹǿȁ ǹǼǿ ǹǼǹ ǹǹǹǽ ǹȁǾ. ǹǹǻ ǹǻUPǹȁ. ôöPGGðøøøHSBGUTXFSFDPOUBNJOBUFEXJUIIJHIQBUIPHFOJDPSHBOJTNTUIFTFXFSFOPUJODMVEFE JOUIJTBOBMZTJT pXJUISBOEPNFĊFDUUPBDDPVOUGPSHSBGUXJUIJOEPOPSTUSVDUVSFBMMFTUJNBUFEFĊFDUT FYQSFTTFE CZUIFPEETSBUJPT BSFBEKVTUFEGPSFBDIPUIFSJOBNVMUJWBSJBUFBOBMZTJT qCMPPETBNQMJOHOPUQFSGPSNFEGPSðóEPOPST JTðóïHSBGUT.
(6) ñó$IBQUFSñ. . .JDSPPSHBOJTNTPGIJHIQBUIPHFOJDJUZ 5XPGBDUPSTXFSFBTTPDJBUFEXJUIBOJODSFBTFESJTLPGDPOUBNJOBUJPOXJUI PSHBOJTNTPGIJHIQBUIPHFOJDJUZ 5BCMF*** "USBVNBUJDDBVTFPGEFBUI JODSFBTFEUIFSJTLCZBGBDUPSPGòó Qïïïö BOEBQPTJUJWFCMPPEDVMUVSF CZBGBDUPSPGôñ Qïïïô *OOJOFPVUPGñõEPOPSTXJUIBQPTJUJWFCMPPE DVMUVSF JEFOUJDBMPSHBOJTNTXFSFGPVOEJOPOFPSNPSFDVMUVSFTUBLFO GSPNUIFHSBGUT. 4ABLE ))) 4HE EFFECT OF VARIOUS FACTORS ON THE RELATIVE RISK OF GRAFT CONTAMINATION WITH HIGH PATHOGENIC ORGANISMS SEE 4ABLE ) ESTIMATED BY ODDS RATIOS. 0REDISPOSING FACTORS FOR BLOOD CONTAMINATION "USBVNBUJDDBVTFPGEFBUIJODSFBTFEUIFSJTLPGCMPPEDPOUBNJOBUJPOCZ BGBDUPSPGðóõ Qïïïð 5JNFGSPNEFBUIBOEQSFDFEJOHPSHBOIFBSU WBMWFQSPDVSFNFOUEJEOPUBMUFSUIFSJTLPGCMPPEDPOUBNJOBUJPO 5BCMF *7 %FFECTIVENESS OF ANTIBIOTIC RINSE "MMUIFBMMPHSBGUTQSPDVSFEGSPNUIFmSTUðôïEPOPST ðôóóHSBGUT XFSF SJOTFEXJUIBOBOUJCJPUJDTPMVUJPO CVUJOUIFMBTUôïEPOPST óôôHSBGUT POMZTBMJOFXBTVTFE.VMUJQMFMPHJTUJDSFHSFTTJPOBOBMZTJTPGUIFEBUB TIPXFEUIBUSJOTJOHXJUIBOBOUJCJPUJDTPMVUJPOEFDSFBTFEUIFSJTLPGDPO UBNJOBUJPOXJUIPSHBOJTNTPGMPXQBUIPHFOJDJUZCZBGBDUPSPGïô Q ïïñ 5BCMF** 'VSUIFSBOBMZTJTTIPXFEUIBUUIJTEFDSFBTFXBTDBVTFECZ BSFEVDUJPOJOUIFOVNCFSPGHSBGUTXJUIBMPXNJDSPCJBMMPBE òðǷWóôǷ CVUUIFSJTLPGDPOUBNJOBUJPOXJUIPSHBOJTNTPGIJHIQBUIPHFOJDJUZEJE OPUBMUFS 5BCMF*** . ñô. $POUBNJOBUJPOPG (SBGUT 'BDUPST 5SBVNBUJDDBVTFPGEFBUI /P OǺǾȁ. :FT Oǽǻ. 1SFDFEJOHQSPDVSFNFOU /P OǺǹǹ. 0SHBO OǾȁ. )FBSUWBMWF Oǽǻ. 5JNFTJODFEFBUI 1FSǺISJODSFBTF 5FBNNFNCFST Ǽ OǾ. ǽ OȂǹ. Ǿ OȂǹ. ǿ OǺǾ. 1SPDVSFNFOUEVSBUJPO 1FSǺISJODSFBTF 5ZQFPGHSBGUT )VNFSVT 3BEJVT 'FNVS 5JCJB 'JCVMB 1FMWJT "DIJMMFTUFOEPO #MPPEDPOUBNJOBUJPOq /P OǺǿǹ. :FT Oǻǿ. "OUJCJPUJDSJOTF /P OǾǹ. :FT OǺǾǹ. /P. :FT. -PHJTUJD3FHSFTTJPOp 0EET3BUJP. ôðƧ$*. ǺǾǿȂ ǼȀǼ. ǼǺ ǻǿ. Ǻ. Ǽǽ. ȂǾǺ ǾȁȂ ǽǹǻ. ǻǿ ǻǻ Ȃ. Ǻ. Ǻǹ ǹȂ. ǹǽUPǼǹ ǹǼUPǼǾ. Ǻǹ. ǹȂUPǺǻ. QWBMVF ǹǹǹȀ. ǻǹUPǾǾ ǹȀǿ. ǹȁǿ ǹȂǼ ǽȀ ȁǽȀ ȁȀǹ ǺȀȁ. ǹ ǻǼ ǻȁ ǿ. Ǻ. Ǻǹ Ǻǹ Ǻǹ. ǹǾUPǺȂ. ǹǿǾ ǺǼ ǺȁǺ ǻǽ ǿǼǼ ǼȂǽ ǻȀǿ ǺǼȁ ǼǻǼ. ǺǺ ǹ ǻǻ Ǿ Ȁ Ǽ ǿ. . ǺǾȂǼ ǻǼǼ. Ȃ ǻǽ. Ǻ. Ǿǻ. ǽǺǺ ǺǽȂǺ. ǽ ǾǼ. Ǻ. ǺȂ. ǹǽUPǽǼ. ǹǹǹǾ ǺǿUPǺȀ ǹǼǹ ǹǾUPǺǺ. XJUISBOEPNFĊFDUUPBDDPVOUGPSHSBGUXJUIJOEPOPSTUSVDUVSFBMMFTUJNBUFEFĊFDUT FYQSFTTFE CZUIFPEETSBUJPT BSFBEKVTUFEGPSFBDIPUIFSJOBNVMUJWBSJBUFBOBMZTJT pMPHJTUJDSFHSFTTJPOPOiUZQFPGHSBGUwXBTJOWBMJECFDBVTFPGTNBMMTJ[FPGUIF TVC QPQVMBUJPOT qCMPPETBNQMJOHOPUQFSGPSNFEGPSðóEPOPSTJTðóïHSBGUT.
(7) ñõ$IBQUFSñ. . 4ABLE )6 4HE EFFECT OF VARIOUS FACTORS ON THE RELATIVE RISK OF BLOOD CONTAMINATION ESTIMATED BY ODDS RATIOS. TUBQIZMPDPDDJ $PSZOFCBDUFSJVN TQFDJFTBOE 1SPQJPOJCBDUFSJVNBDOFT BOE QSPCBCMZSFQSFTFOUFYUFSOBMDPOUBNJOBUJPOBUUIFUJNFPGQSPDVSFNFOU 0SHBOJTNTPGIJHIQBUIPHFOJDJUZQSPCBCMZPSJHJOBUFGSPNFOEPHFOPVT TPVSDFTJOUIFEPOPSɨFZBSFVTVBMMZDPOUBNJOBOUTGSPNUIFVQQFSSFTQJ SBUPSZPSHBTUSPJOUFTUJOBMUSBDU FHTUSFQUPDPDDJ 4UBQIZMPDPDDVTBVSFVTBOE &TDIFSJDIJBDPMJ BOEBSFNPSFMJLFMZUPDBVTFJOGFDUJPOJOUIFSFDJQJFOUPG UIFBMMPHSBGU 'PSFBDITUBĊNFNCFSBEEFEUPUIFQSPDVSFNFOUUFBNUIFSJTLPG DPOUBNJOBUJPOXJUIPSHBOJTNTPGMPXQBUIPHFOJDJUZJODSFBTFECZBGBD UPSPGðõ.JDSPPSHBOJTNTTIFEGSPNUIFTLJOPGUIFTUBĊBSFDPOTJEFSFE UIFNBKPSTPVSDFPGBJSCPSOFCBDUFSJB BOEBSFEFQPTJUFECZHSBWJUZPOUP UIFTVSGBDFPGUIFHSBGUT ðó*ODPOWFOUJPOBMMZWFOUJMBUFEPQFSBUJOHSPPNT BSPVOEøôǷPGUIFXPVOECBDUFSJBDPNFGSPNUIFBJS ðô ðõ8FSFDPNNFOE UIBUBMMPHSBGUQSPDVSFNFOUTIPVMECFQFSGPSNFECZBTNBMMBOEFYQFSJ FODFETVSHJDBMUFBN ɨFQSPDVSFNFOUPG"DIJMMFTUFOEPOTXBTBTTPDJBUFEXJUIBOJODSFBTFE SJTLPGDPOUBNJOBUJPOXJUITLJODPNNFOTBMT"EIFTJWFESBQFTVTFEBUUIJT TJUFXFSFGSFRVFOUMZGPVOEUPEFUBDI"TUIFUFOEPOTXFSFUIFMBTUUPCF SFNPWFEUIFSFXBTBHSFBUFSSJTLPGUIFJSDPOUBDUXJUIIFBWJMZDPOUBNJ OBUFETVSHJDBMESBQFTPSJOTUSVNFOUT 8FGPVOEJUJOUFSFTUJOHUIBUQSFDFEJOHQSPDVSFNFOUPGPSHBOTPSIFBSU WBMWFTEJEOPUJOnVFODFUIFSJTLPGDPOUBNJOBUJPOXJUIMPXQBUIPHFOJD PSHBOJTNT8FTVHHFTUUXPFYQMBOBUJPOT'JSTU NJDSPPSHBOJTNTTIFE GSPNUIFEJĊFSFOUTUBĊQFSGPSNJOHUIFQSFDFEJOHQSPDVSFNFOUBSFBSFMB UJWFMZTNBMMSJTLGPSDPOUBNJOBUJPO BMSFBEZIBWJOHTFUUMFEUPUIFnPPSBOE PUIFSTVSGBDFT1BSUJDMFTTFUUMF NPWFEPXOXBSET BUBTQFFEPGñïUPòï DNNJOðó0ODFTFUUMFEPOUIFnPPSPSBOPUIFSTVSGBDF PSHBOJTNTBSFPOMZ SFTVTQFOEFEJOUPUIFBJSXJUIHSFBUEJċDVMUZ ðö4FDPOEMZ EVSJOHEPOPS BOECBDLUBCMFQSFQBSBUJPO UIFOVNCFSPGPSHBOJTNTJTJODSFBTFETVCTUBO UJBMMZ0VSNFBTVSFNFOUPGDPMPOZGPSNJOHVOJUT $'6 JOUIFPQFSBUJOH UIFBUSFTIPXFEBNFBODPVOUPGô$'6Nò ïUPðõ JOBOFNQUZPQFSBUJOH UIFBUSFKVTUCFGPSFUIFQSPDVSFNFOUXJUIBTIBSQSJTFUPõô$'6N ò ÷UP ñòô EVSJOHEPOPSBOECBDLUBCMFQSFQBSBUJPOɨJTXBTJOEFQFOEFOUPGBOZ QSFDFEJOHQSPDVSFNFOU#ZUIFUJNFUIFTVSHJDBMFYDJTJPOPGUIFBMMPHSBGUT PDDVSSFEUIFOVNCFSIBEESPQQFEUPñô$'6Nò ïUPðñô $POUBNJOBUJPOXJUIPSHBOJTNTPGIJHIQBUIPHFOJDJUZDBOCFSFEVDFE CZDBSFGVMEPOPSTFMFDUJPO*GUIFSFIBECFFOUSBVNBUPUIFNBYJMMPGBDJBM BSFBPSBCEPNFOCBDUFSBFNJBJTMJLFMZUPPDDVSXJUIIBFNBUPHFOPVTTQSFBE. 'BDUPST 5SBVNBUJDDBVTFPGEFBUI /P OǺǽȀ. :FT OǼȂ. 1SFDFEJOHQSPDFEVSF /P OȂȁ. 0SHBO OǾǹ. )FBSUWBMWF OǼȁ. 5JNFTJODFEFBUIq 1FSǺISJODSFBTF. $POUBNJOBUJPOPG (SBGUT /P :FT. -PHJTUJD3FHSFTTJPOp 0EET3BUJP. ôðƧ$*. ǾǺUPǽǼ. ǺǼȀ ǻǼ. Ǻǹ Ǻǿ. Ǻ. Ǻǽǿ. ȁǼ ǽǿ ǼǺ. ǺǾ ǽ Ȁ. Ǻ. ǹǽ ǹǿ. ǹǺUPǺǾ ǹǻUPǻǻ. Ǻǻ. ǺǹUPǺǾ. QWBMVF ǹǹǹǺ. ǹǽǻ. ǹǹȁ. BUPUBMPGð÷õCMPPEDVMUVSFTXFSFBOBMZTFE JOðóPVUPGñïïEPOPSTCMPPETBNQMFTXFSFOPU PCUBJOFEEVFUPUFDIOJDBMSFBTPOT pXJUISBOEPNFĊFDUUPBDDPVOUGPSHSBGUXJUIJOEPOPSTUSVDUVSFBMMFTUJNBUFEFĊFDUT FYQSFTTFE CZUIFPEETSBUJPT BSFBEKVTUFEGPSFBDIPUIFSJOBNVMUJWBSJBUFBOBMZTJT qJGUIFSFXBTBQSFDFEJOHQSPDFEVSFUIFTBNQMFTXFSFUBLFOBUUIFUJNFPGUIFQSFDFEJOHQSPDVSF NFOUUPFYDMVEFCJBT XFPOMZBOBMZTFEQSPDVSFNFOUXJUIPVUQSFDFEJOHPSHBOIFBSUWBMWFQSP DVSFNFOU. $)3#533)/. %FTQJUFDBSFGVMEPOPSTFMFDUJPOBOEBTFQUJDUJTTVFQSPDVSFNFOU XFGSF RVFOUMZDVMUVSFENJDSPPSHBOJTNTGSPNCPOFBOETPGUUJTTVFBMMPHSBGUT ɨPTFPGMPXQBUIPHFOJDJUZ XIJDIXFDPOTJEFSFEUPCFTLJODPNNFOTBMT XFSFDVMUVSFEGSPNôïǷPGUIFHSBGUT5XPUIJSETPGUIFTFHSBGUT õøǷ IBE XIBUXFUFSNFEMPXNJDSPCJBMMPBE.JDSPPSHBOJTNTPGIJHIQBUIPHFOJD JUZXFSFDVMUVSFEGSPNPOMZòǷPGUIFBMMPHSBGUT0UIFSTIBWFSFQPSUFESBUFT PGCBDUFSJBMDPOUBNJOBUJPOCFUXFFOôǷBOEóóǷ ðô$PNQBSJTPOPGUIF DPOUBNJOBUJPOSBUFTJOUIFTFSFQPSUTJTOPUQPTTJCMFCFDBVTFPGEJĊFSFODFT JODVMUVSFUFDIOJRVFTPSMBDLPGJOGPSNBUJPOBCPVUUIFUFDIOJRVFVTFE #MPPEDVMUVSFTGSPNðóǷPGUIFBMMPHSBGUEPOPSTXFSFQPTJUJWF 4USFQUPDPDDVT TQFDJFTCFJOHNPTUGSFRVFOUMZHSPXOɨJTBHSFFTXJUIBOPUIFSSFQPSU ðòJO XIJDIBDPNQBSBCMFQFSDFOUBHFPGCMPPEXBTDPOUBNJOBUFEXJUIPSHBO JTNTPUIFSUIBOTLJODPNNFOTBMT 8FBSFPGUIFPQJOJPOUIBUJUJTJNQPSUBOUUPEJTUJOHVJTICFUXFFO BMMPHSBGUDPOUBNJOBUJPOXJUINJDSPPSHBOJTNTPGMPXBOEIJHIQBUIPHF OJDJUZ BTUIFZBSFMJLFMZUPPSJHJOBUFGSPNEJĊFSFOUTPVSDFT.PTUPSHBO JTNTPGMPXQBUIPHFOJDJUZBSFTLJODPNNFOTBMT FHDPBHVMBTFOFHBUJWF. ñö.
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GERELATEERDE DOCUMENTEN
License: Licence agreement concerning inclusion of doctoral thesis in the Institutional Repository of the University of Leiden Downloaded from: https://hdl.handle.net/1887/3765.
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Note: To cite this publication please use the final published version (if applicable)... *\YYPJ\S\T=P[HL 3VVE%FJKLFSTXBTCPSOPO'FCSVBSZñ÷ ðøõðJO4UBOEEBBSCVJUFO
Massive deep-frozen bone allografts : contamination, immunogenicity and clinical use Deijkers,