Country’s lone human tissue bank serving in silence

When Shreyon Paul suffered a second-degree burn to his back, doctors at a local hospital were not sure if the nine-year-old would ever fully recover.

The deep burn from boiled water had destroyed the affected tissues, they told his father Swapan Paul, from Gazipur.

After he was taken to Shaheed Tajuddin Ahmad Medical College Hospital in Gazipur, doctors told the desperate father about amniotic membrane treatment. It is a therapy to help stimulate tissue growth more quickly and efficiently than traditional skin grafting and is available at the public hospital.

The thought of the cost worried Swapan. However, when he went to collect the tissue at the Institute of Tissue Banking and Biomaterial Research (ITBBR), the country's lone tissue bank in Savar, he was surprised and relieved at once.

There was little hassle and it cost him almost "nothing", given the gravity of the burn in his son's body. "I collected the tissue for a token amount, which was a great help for me," he said.

If recommended by a public hospital doctor, poor patients can get it even for free.

Back at Shaheed Tajuddin hospital, doctors placed the required amnion tissue on Shreyon's wound a day after its collection, and it started healing rapidly.

"My son is doing great now and the scars have also faded," Swapan told The Daily Star.

Shreyon is not alone. Many patients in need of tissue for transplant and bone grafting are turning to the Institute.

From 2009-2020, the bank has provided more than 1.39 lakh cubic metres of bones and 54,768 pieces of amniotic grafts to hospitals and clinics for use in various surgeries. During the same period, 8,351 patients went through tissue transplants with the help of doctors and scientists at the Institute for a nominal price.

In some cases, the cost is 10 times lower than that in India, doctors said.

In Bangladesh, tissue-banking research started in the '90s at Bangladesh Atomic Energy Commission (BAEC) with support from IAEA Research Programme. From 1997 to 2002, Bangladesh received required skills development training and research assistance under the IAEA-Gi Regional Cooperative Agreement.

Later in 2003, BAEC launched an independent laboratory -- Tissue Banking-and Biomaterial Research Unit - in Savar. It was renamed as Institute of Tissue Banking and Biomaterial Research in 2017.

Institute Director and Chief Scientific Officer Dr SM Asaduzzaman said that apart from tissues, they collected amputated bones and skulls from hospitals and stored them in sterile boxes in laboratory freezers.

Parts of amniotic sacs, commonly called bag of waters in which embryos and later fetuses develop in amniotes, are used for tissue transplants as they help burn wounds heal fast. They are collected from hospitals where mothers have just given birth.

The bank controls microbiological quality of the grafts and stores them at minus 40 to 80 degree Celsius following guidelines from the International Atomic Energy Agency (IAEA).

The work force is small -- the Institute has only eight scientific officers and fifteen laboratory and administrative staff. Still it has collected 15,419 amniotic sacs and 8,287 bones from different hospitals from 2009 to 2020, said Asaduzzaman.

Md Sanaullah, a day labourer from Bhola, is another beneficiary of the tissue bank. He had been suffering from a foot tumour for long and could not walk properly for more than two years. Recently, he collected bone tissues from the bank for just Tk 3,000 for his upcoming surgery at Bangabandhu Sheikh Mujib Medical University in Dhaka.

"We thought these surgeries were very expensive. Given our poor financial condition, we were preparing to accept the reality. But the doctors here have assured us that he'll do fine after the operation," said Sanaullah's brother-in-law Md Taiyasb.

Apart from collecting and supplying amniotic sacs and bone tissues, the bank has so far helped in transplanting 347 skulls.

"If someone has an injury or infection in the head, doctors usually inform the bank to collect and process the skull through cold sterilisation, which is later repaired during the surgery," said Asaduzzaman.

The Institute provides tissues to over 100 hospitals and clinics for surgical treatment across the country, after authorisation by doctors of the hospital concerned. The Institute verifies the doctor's identity, and then provides the processed tissues to the patient's representative.

"Suppose a patient developed cancer from a foot tumour. If he collects bone tissues from us and undergoes a surgery at a government hospital like National Institute of Traumatology and Orthopaedic Rehabilitation, it will cost him around Tk 20,000. This includes the surgical and medical bills," Asaduzzaman said.

Similar treatments in India would cost about Tk 2 lakh, he added.

Recently, the government has approved a Tk 173-crore project for the expansion of the Institute and establishment of a full-fledged Human Tissue Bank.

After the fund approval on July 28, Planning Commission Member Nasima Begum said many people did not know that the Institute even existed, especially in a country where accidental injuries are high.

In 2020, more than 8,600 people were injured in about 4,900 road accidents alone, according to Bangladesh Passengers Welfare Association.

The Institute is a big support for patients like them, particularly for those who lack financial means to go abroad for treatment, Nasima said.

"We hope their activities will expand with the new project and patients countrywide can also avail these services at a nominal price," she added.