12.2 Autograft Tissue Donors

More often, tissue transplantations from living donors concern autologous grafts. Autologous grafts have the advantage of providing active living cells and tissue matrix on the recipient site. They are easily integrated with few local reactions but are necessarily limited in volume and associate with morbidity at the donor site.
With bone autograft donations, the most frequent complications other than those from the anaesthesia, involve the donor site:

  • Hematoma;
  • Wound infection;
  • Persistent pain and nerve injury;
  • Bone fracture, e.g. iliac crest
  • Fatigue fracture, e.g. tibial;
  • Scar.

Nerve injuries are usually related to sensory symptoms such as pain, anaesthesia or paraesthesia. Motor sequella are rare and usually due to a surgical error. Sensory problems are immediate, and often resolve spontaneously within 3 to 6 months. Some are permanent. After extraction of the autologous bone graft, a bone defect will remain at the donor site. Depending of the size, location and configuration of the defect, a fracture or a fatigue fracture could develop.