Macewen first describes the use of allogenic human bone tissue in 1881 (Macewen 1881). From that year onwards, the use of allogenic bone transplantation has been increasingly applied and is nowadays a standard orthopaedic procedure (Tomford et al. 1987) . However, much has changed in the past decade: donor selection, clinical hygiene, storage and processing, allocation, implantation, and documentation are bound to strict rules. Donor selection takes place by a thorough broad survey and supplementary physical examination. The survey should be regularly revised to comprise the latest knowledge and developments, and as a response to the spread of new infectious diseases. For instance, after the outbreak of the SARS epidemic in certain countries, a question was added to the survey; prospective donors were asked whether they had been in SARS-infected regions or whether they had been in contact with an infected person. It is not unthinkable that newly arising infectious diseases will be included in the survey and henceforth become exclusion criteria. Laboratory examination is performed before surgery, including ESR determination. Elevated values are often encountered, often without clinical implications. However, the exclusion criteria are strictly enforced. Preoperatively, blood type and Rh-factor are determined. The Rh-factor only becomes an issue if the receiving patient is a young woman. Additionally, the donor is serologically examined, to exclude possible transmission of infections, such as HIV and hepatitis (Strong et al. 1996; Shutkin 1954; Patel and Trampuz 2004; Karcher 1997) . The serological tests are carried out at least 6 months after surgery to avoid type II error (false negative): if the patient was infected at the time of surgery, the test will provide conclusive evidence of this. Normally, the donor will not be informed of the results, unless specifically requested by the donor.