Interesting Twist: Australia’s tissue industry over regulated?

While here in the US the tissue industry is largely unregulated, in Australia they appear to have the opposite problem.  They are actually importing tissue from the US when it is available.  Here’s a great article that talks about the plight of one recipient:

Donor shortage left fire survivor facing the fight of her life

July 19, 2012

Julie Robotham, Linton Besser

Ultra marathon runner Turia Pitt sustained burns to 64% of her body when caught in a bushfire last September. Turia spoke to Kate Geraghty about her skin grafts.

IN THE long roll-call of people who saved Turia Pitt’s life last year are fellow athletes, surgeons, a helicopter pilot, and at least three unidentified Americans who were already dead.

The 24-year-old’s heroic evacuation out of the Kimberley in Western Australia in September, after a savage bushfire cut off her path in a 100-kilometre ultramarathon race and burnt her catastrophically, was only the start of a harrowing six-month journey to hospital discharge.

All the skills of Concord Hospital’s burns unit could not prevent infection taking hold in Miss Pitt’s wounded back and legs, and human skin – taken from cadavers and laid in strips over burns – represented her best chance of survival.

SMH NEWS 18 July 2012. Turia Pitt with her partner Michael Hoskin in Kununurra. Turia Pitt suffered 64 per cent burns when she was trapped by fire during a 100km ultramarathon last September in the Northern Territory. SuppliedBefore the tragedy … Turia Pitt.

But the only facility that harvests and processes the temporary grafts had none in its bank – the result of policies that reduce its capacity to stockpile disinfected and frozen skin, leaving the nation dangerously dependent on imports.

The Donor Tissue Bank of Victoria instead had to beg for the precious resource from its counterpart in California, whose quality controls had been previously approved by the federal Department of Health and Ageing after the Victorian bushfires.

”They wrapped me in plastic but that didn’t work. I was shocked that we didn’t have [donated skin] in Australia,” Miss Pitt said this week at her mother’s home in Ulladulla.

Her story has surfaced as part of a Heraldinvestigation into the global trade in human body parts by public and private institutions.

Miss Pitt was fortunate; the US bank had skin available, though its arrival was delayed several days while doctors organised customs and health clearances and a courier flight.

The Californian bank has turned down two of four previous Australian requests – during its own bushfire crisis, and when stored skin did not have family consent for export.

The head of the Victorian tissue bank, Stefan Poniatowski, said human skin had oxygen-conducting and infection-fighting properties unmatched by artificial substitutes, but it had to be changed frequently, meaning three or four donors were needed to treat one severely burnt patient. ”What Australia really needs is a national contingency reserve of skin. Australia needs to become self-sufficient.”

Of 20 to 30 requests a year, he said, ”a third of the time we won’t be able to facilitate the request”.

Mr Poniatowski said new privacy rules around deaths examined by the Victorian coroner – which provide the bulk of skin donations – made it more difficult to obtain medical histories, ruling out potential donors. As well, he said, legislation allowed tissue banks only to recoup strictly defined costs, affecting their ability to pay on-call retrieval technicians.

Federal government figures show there were 66 skin donors in 2011, 19 of whom also gave organs. Australia’s precarious skin supply reflects a wider malaise in tissue donation – of skin, bones, heart valves, tendons and corneas – as the government focuses on high-profile kidney, lung and heart transplantation programs, say people working in the sector.

Robert Herkes, NSW medical director of the Australian Organ and Tissue Authority, said the sector, run by state governments and charities, was ”tiny … and all funded by cost recovery”, severely limiting its capacity to pay for even essential capital items such as new freezers.

A report by the authority acknowledged there was ”a limited and irregular supply available to treat burns victims outside of Victoria”.

It said a newly licensed Queensland skin bank would treat patients in that state and ”may also be able to establish a stored supply of cadaveric skin … in the event of a serious disaster.”

Miss Pitt said: ”After what happened to me a lot of friends and family who weren’t donors changed that [on their driver’s licence record]. I was already a donor but I didn’t tick the box for skin. I think maybe if people knew what it was used for and how it saves lives they’d be more willing to donate it.”

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