Abstract
Purpose: :
Donor corneas for corneal transplantation are in short supply, specifically in the majority of European countries. In 2007, European Union 'technical requirements for the donation, procurement and testing of human tissues and cells' restricted the usability of post-mortem donor blood sampling from 48 hours to 24 hours (EU Directive 2006/17/EC). This lead to a factual tightening in post-mortem time for donor cornea acquisition, thus aggravating the shortage of donated corneas throughout European eye banks. This study was performed to gain insight whether donor corneas during preservation benefit from this restriction.
Methods: :
Retrospective comparison of contamination rates during corneal organ culture during extended (2008-9, Group I) versus restricted post-mortem time protocols(2010-11, Group II). Data were collected at LIONS Cornea Bank North Rhine-Westphalia, University Eye Hospital Duesseldorf, Germany.
Results: :
During extended acquisition guidelines (Group I) 1272 corneal grafts with a post-mortem time of 30.05 ± 15.77 hours were allocated and subsequently cultivated. By introducing the restricted guidelines, the overall number of collected (= stored) donor corneas dropped by 29.88% to 892. Post-mortem time was significantly reduced to 24.2 ± 12.37 hours (p<0.05, t-test). During extended procurement contamination rate was 9.0% (n=115, Group I). Interestingly, reduction in post-mortem time did not result in a significant decrease of corneal contamination Group II: 7.3%, n=65; Chi-squared test).
Conclusions: :
These findings suggest that restriction of donor cornea acquisition time down to 24 hours is without benefit regarding frequency of contamination during organ culture storage. Further analyses regarding possible difference in corneal endothelial cell count or false-positive serology (e.g. Hepatitis, HTLV) yet are required.
Keywords: cornea: storage • transplantation