INTRODUCTION
The Thai Association of Tissue Bank was founded on 1st January 2001. This was a long dream come true for its founder President Prof. Dr. med. Yongyudh Vajaradul who also happens to be the founder of the Asia Pacific Association of Surgical Tissue Banks.
The foundation and strengthening of tissue banking concept in Thailand has a glamourous genesis. After completing his Facharzt in Orthopaedic surgery and Doktor der Medizin from Germany in 1974, when Prof. Yongyudh came back to Thailand, he started working at the Siriraj hospital. At this time he was very much interested to carry on research on bone healing process. He had two options viz. 1) Bone healing by electrical stimulation and 2) Bone healing by the use of allografts. He noted that the results of using allografts were more promising and thereby he embarked on this concept to carry on his clinical research studies. The first allograft surgery was done at Siriraj hospital in June 1979 and after having successful results for the first 26 cases, he reported it at the Regional Co-operation Agreement (RCA) meeting of International Atomic Energy Agency (IAEA) at Bombay, India in the year 1982. After the foundation of the Bangkok Biomaterial center in 1984, he had pursed very actively on finding newer methods and techniques for the processing, storage, sterilization, packaging, distribution, clinical application and tissue donation campaigns. During this time allografts prepared at the Bangkok Biomaterial Center were primarily freeze dried bones and sterilized by Ethylene oxide gas (ETO). The Bangkok Biomaterial Center embarked on with the processing of Deep-Frozen allografts at – 70? C. At this time, during 1984, sterilization technique was changed to gamma ray irradiation. During the following years, Prof., Yongyudh had noticed that preparation of freeze-dried and deep frozen does not takes the TB in the long run. Concurrently at this time there was introduction of metallic and plastic artificial implants, and fibrosis around them were proving as the real danger. Prof. Yongyudh was of the opinion that if freeze-dried Dura Mater is wrapped around the artificial implants, then it will mimic the soft tissues around them and thereby prevents fibrosis. This gave birth to procurement and processing of Dura Mater and Fascia Lata. Going down the years, it was felt that maintaining records and proper documented of the recipients, donors and a strict follow-up was also very essential. The Bangkok Biomaterial Center started a very strict protocol of documentation, which is maintained religiously by the staff.
However just producing and using the allografts by one man was not sufficient to bring in a revolution. The need of time was that more and more surgeons use allografts and also other branches of medical fraternity join in to provide feedback and conduct vigorous pathological, biochemical and other laboratory tests to prove the effectiveness of allografts over other artificial products. During 1988, Prof. Yongyudh became the Secretary General of the International College of Surgeons (ICS), an esteemed association having expert surgeons and clinicians from all disciplines of medical science. Taking advantage of his appointment, Prof. Yongyudh urged the members of ICS to use the allografts to demonstrate its effectiveness and complications. This paved the way for the organizing of the 1st workshop in 1989 for tissue bank operators and users in Bangkok. At this time Prof. Yongyudh was also of very strong opinion that there was a very strong need for an association in the Asia Pacific Region which would bring in Tissue bankers, surgeons, clinicians, scientists and tissue bank workers together on a common platform to share their scientific knowledge and experience about tissue banking. At the same time this association will provide the umbrella support under which technology transfers, scientific know-how exchange, sharing of tissue allograft and personnel can also take place. Thus gave the birth to the Asia Pacific Association of Tissue Banking (APASTB) in 1988 and its 1st conference was combined with the workshop of the tissue bank operators. Prof. Yongyudh was the founder President of APASTB and held this appointment for 2 years. From 1990-1998, he also served as the secretary general of APASTB. In 1999, he was honored with the honorary membership of European Association of Tissue Banks (EATB) at the 2nd world congress of Tissue Banking held at Warsaw, Poland.
As time passed by, number of allograft users were growing and so was the demand also. A time came when the Bangkok Biomaterial Center was left with very small stock of bone allografts. This gave rise to a new problem and that was to find the sources for the availability of bones and tissues. During the 70s and 80s, we have witnessed the hurdles sustained by the blood donation campaigners. It was considered an uphill task and millions of dollars were pumped all over the world employing every option in the media to change the public opinion towards blood donation. However blood donation was a different story, that people can consent for it in the event of an emergency because it did not affect their body.
However asking for donation of human bones and tissues was a very different story. It was a very vague term for the general public as well as medical professionals. In the entire Asia Pacific region, it was only in the textbooks that public donation of human bones and tissues was possible. The socio-religious environment in the Asian countries is very different from those of Europe and Americas. There were many social and religious beliefs that if any part of the human body is lost or removed from one’s body then they will be born deficient of that part in their next life. Furthermore the social stigma of asking for bones and tissues from the deceased or the living people was very embarrassing. Last of all personal and professional integrity of the campaigners to avoid any commercial or monetary overtones to the public donation was the most dreaded. These factors complicated the whole scenario. It was no more blood donation. Now the story was Bone and tissue donation.
Somewhere the start has to be made by someone. With this logic, Prof. Yongyudh went ahead with his mission to make this dream turn into a reality. A dream if fulfilled will strive to serve for the betterment of mankind. In 1984, Bangkok Biomaterial Center in association with the Forensic Medicine department, Siriraj Hospital made a Tissue donation study on the attitude of next of kin who comes for taking back the deceased body for cremination. It was found out that in the mourning situation response of people involved directly to the deceased was not positive. We had only 30% consent from the next of kin or relatives. Another 60 % were against tissue donation and the rest 10% had no response. This study showed that there was a desperate need of an aggressive campaign for tissue donation. The first report of successful allograft transplantation was announced in leading newspapers like Bangkok Post, Thairat and Khasot. This was followed by the first TV programme titled “Tissue Transplantation” on TV Channel 9 in 1989. These two events were the beginning of a never-ending saga of public donation campaign of human tissues.
This was the beginning of the public donation campaigning. However within a short time Prof. Yongyudh realized that it was equally important to start a Professional Awareness programmes also for medical professionals from various disciplines of medicine. Thus he went ahead with the idea and organized the first Medical resident’s seminar at Siriraj Hospital in 1995. This was followed by rigorous hard work towards lecturing on tissue banking concept, processing/ preservation/sterilization/storage/packaging/transportation techniques and ethics. Demonstrating surgical techniques for the application of allografts went parallel to the lectures. Soon there were requests from hospitals all over Thailand, and ASEAN countries for expert lectures in tissue banking and demonstration surgeries using allograft.
With the advent of time, tissue allograft demand increased and so were the users also, who had spread all over Thailand. It was felt necessary to establish regional tissue banks across Thailand. As a first step towards this, it was necessary to train the clinicians in the discipline of tissue banking before commencing on the setup of tissue banks. The Bangkok Biomaterial Center started the short time Post Graduate Course of 1 week for training Clinicians about Tissue Banking at the premisis of the Center. This program started on the 1st of January 1996. With the growing number of trained tissue banking clinicians, it was essential to form an association to bring togther the benefits of collectiveness. Thus was born the THAI ASSOCIATION OF TISSUE BANKS.
TATB & the Bangkok Biomaterial Center (BBC): The relationship of TATB is like a training institute, which has catered to the need and number of Tissue Bankers & Users all over Thailand. In fact every member of TATB has been associated with BBC at some stage either as a user, trainee or Trainer. The BBC has been the loci for the establishment of TATB.