Baffled health officials await an explanation while patients suffer as their operations may be delayed The Shenzhen authorities are rejecting bone and skin tissue sent from Hong Kong for sterilisation under a long-standing arrangement and local health officials are still trying to find out why. The tissue, used in reconstruction surgery, has been rejected since December and this could delay surgery on patients waiting for bone and skin grafts. Hong Kong sends tissue to a Shenzhen plant for sterilisation by irradiation because it does not have the facilities. 'We are still seeking information from the relevant departments on the mainland,' a spokeswoman for the Health, Welfare and Food Bureau said. Ip Wing-yuk, associate professor of orthopaedic surgery at the University of Hong Kong, estimated at least 20 patients at Queen Mary Hospital needed human bones for major reconstructions every year. Artificial bones can be used in many cases, but Dr Ip said human bones were better for some patients, such as those who needed major reconstructions after removal of a tumour. Medical sources said Hong Kong hospitals would send tissue to the mainland for irradiation about three times a year. Madhukar Kumta, associate professor of orthopaedics and traumatology at the Chinese University, said sterilisation was needed to avoid transmission of disease to recipients. Professor Kumta is also the director of the musculoskeletal tissue bank at Prince of Wales Hospital, the teaching hospital of the Chinese University. Prince of Wales Hospital and Queen Mary Hospital, another teaching hospital, are the only ones to have a bone tissue bank. 'We are keeping the bones in a freezer. We will wait until this is sorted out,' Professor Kumta said. 'When human tissue goes across borders there are legitimate concerns. They relate to the possibility of disease transmission and also the possibility of abuse of the system. 'We are not sure what is going on over the other side.' He said one possibility was that there had been a change of officials and the new people were looking at the detailed documentation involved. 'They [may] want some clarification about the source of the bones, or whether they were legitimately taken,' Professor Kumta said. He said Hong Kong surgeons followed guidelines established by the American Association of Tissue Banks and Asia Pacific Association of Surgical Tissue Banking that called for terminal sterilisation. There were other sterilisation methods such as chemicals, but irradiation was still the safest if properly done. 'It reduces the chance of possible disease transmission from a variety of contamination agents,' he said. Professor Kumta said his concerns were more about the shortage of donations. Last year, there were only four donors of bone and none at all in 1993, according to the Hospital Authority. There were 30 skin donors last year, and five in 1993.