By Jessica Bernstein-Wax, The Marin Independent Journal
It's easy to ignore the innocuous office building at 2597 Kerner Blvd. in San Rafael, California where Tissue Banks International processes and stores thousands of musculoskeletal tissue donations and corneas each year.
But while the organization's San Rafael location may be unassuming, it serves a crucial function for patients throughout Northern California and the country who receive tissue for spinal surgeries, skin grafts and vision-restoring corneal transplants. Industry experts say the 28,000-square-foot San Rafael facility -- which Tissue Banks International, or TBI, took over in 1995 -- is Northern California's only musculoskeletal tissue processing center.
The Baltimore-based nonprofit also recently expanded its San Rafael eye bank so corneas can make their way to local recipients more quickly, said Jeff Sandler, the facility's chief operating officer.
Surgeons generally must transplant corneas within five to eight days of the donor's death, and eye donations must undergo screening and processing before that can take place, Sandler said.
"The ironic thing is what you're looking for is a healthy dead person," Sandler said during a recent tour of the San Rafael site. "With corneas, you've got a short period of time, a couple of days, to make that."
While TBI returns most finished tissue products back to the communities where they were obtained, the nonprofit was
previously processing most corneas procured in California at a site in Memphis, Tenn., he said. By expanding the San Rafael eye bank, more corneas can go to in-state recipients.
"FedEx is terrific, but you can't get a delivery on Sunday," Sandler said. "We weren't getting the corneas procured here back into the local area fast enough."
Of the approximately 40,000 musculoskeletal products the nonprofit prepares each year in San Rafael, about 30,000 stay in California, he noted.
At TBI's maze-like San Rafael building, technicians -- some of whom are physicians from overseas -- prepare tendons, skin, femurs and eyes taken from local patients who were organ and tissue donors in seven "clean," specially filtered rooms. Workers store the tissue in refrigerators with temperatures as low as minus 80 degrees centigrade and later distribute the finished products to doctors, hospitals and medical device companies.
"TBI is by far the largest eye and tissue bank in the north Bay Area and works closely with our partner organization, the California Transplant Donor Network, to recover the majority of tissues in the community, which are then prepared for transplant at TBI's San Rafael facility," TBI spokeswoman Angela Ortado said.
TBI employs 255 people nationwide and 64 people in San Rafael, its largest location. The nonprofit operates other sites throughout the United States, with offices in Connecticut, Texas, New Mexico, Ohio and other states.
The organization derives most of its $42 million annual budget from reimbursement for tissue processing but also gets 2 to 3 percent of its operating budget from donations, Ortado said.
The U.S. Food and Drug Administration has overseen tissue banks since the mid-1990s, Sandler said. Because most of the banks are nonprofits with limited funding, the organizations rely primarily on medical device companies and universities for innovations, he said.
Tissue donations are generally easier to come by than organs, primarily because doctors may extract them for 24 hours after death and a patient must only be declared legally dead rather than brain dead for the donation to take place, said Matthew Crump, director of tissue services at the California Transplant Donor Network, which partners with TBI.
"Organ donation is lifesaving, and it's absolutely critical," Crump said. "Tissue donation can be lifesaving as well. It can be life-enhancing. It really depends on what kind of tissue you're talking about."
California residents may sign up to become organ or tissue donors during their lifetimes, or their relatives may consent to donation after death. There are about 140 Marin residents on the waiting list for organ donations and about 22,000 people are waiting in California, the California Transplant Donor Network said.
Most corneas from donors who die in the North Bay are likely to go to TBI for processing, and about 50 percent of musculoskeletal tissue will make its way to the organization, Crump said.
"TBI is a good organization," Crump said. "They are working hard to process and distribute much-needed tissues back into the Bay Area, California, as well as across the nation."