ABSTRACT Background Microbial contamination of musculoskeletal tissues recovered from deceased donors poses a risk for donor‐derived infections and may lead to tissue exclusion under regulatory standards. Despite stringent aseptic protocols, recovery and processing contamination remains a critical challenge. This study presents a large‐scale analysis of microbial prevalence and distribution in deceased tissue donors in the United States. Methods We conducted a retrospective analysis of 1 186 392 musculoskeletal tissue recovery swabs collected from 69 920 deceased donors between 2019 and 2024. Growth‐positive cultures underwent organism identification using MALDI‐TOF mass spectrometry and biochemical methods. Microbial findings were stratified by anatomical recovery zone, and organisms considered potentially disqualifying for transplantation were assessed according to American Association of Tissue Banks (AATB) standards. Results Microbial growth was observed in 12.4% of swabs, with 64.8% of donors having at least one growth‐positive sample. Among positive swabs, 92.4% yielded bacteria, 5.0% fungi, and 2.6% yielded both. Organisms considered potentially disqualifying were identified in 5.0% of donors, most commonly Clostridium species and Streptococcus pyogenes . The prevalence of virulent organisms varied by anatomical recovery zone, with the highest rates observed in lower extremity and pelvic sites and the lowest in thoracic and vertebral tissues. Conclusion In this large national cohort, potentially virulent microorganisms were identified in a clinically meaningful proportion of deceased tissue donors, with substantial anatomical variability in contamination risk. These findings reinforce the importance of stringent microbiological screening to reduce the risk of recipient infection while supporting safe and effective tissue transplantation.
Montedonico et al. (Thu,) studied this question.