Impact of Organ Culture Storage on donor corneas: A comparison of different age groups

Abstract

Purpose : Anecdotally, Eye Bank experience has suggested that corneas from older donors show less endothelial cell loss and better viability than corneas from younger donors in organ culture. The purpose of this study was to evaluate the corneal endothelial cell density and the impact upon viability for transplantation from different donor age groups, stored in organ culture medium.

Methods : Cornea storage data from the Lions New South Wales Eye Bank between January 2014 and December 2015 were reviewed retrospectively. The corneas were divided into 5 age groups: age ≤40 years; age 41-50 years; age 51-60 years; age 61–70 years and age ≥71 years. Pearson’s correlation coefficient was used to evaluate the relation between age and endothelial density or viability. Other risk factors related to the endothelial density and viability were also assessed. Generalized estimating equation method was used to analyse the impact of age and the other factors on endothelial density, cell loss (the difference between final and initial cell count) and viability respectively, while allowing for possible correlation within each pair of eyes included in this study.

Results : A total of 1390 corneas were included in the analysis. The mean age at the death was 61.02±13.72 years (range from 8 to 97 years). At the end of the storage, the mean final endothelial density was 3103.4±364.53 cells/mm² and mean viability was 94.66±5.98%. Mean cell loss was 170.5±178.95 cells/mm². Of the data, 3.6% (50/1390) corneas had either viability ≤70% or final cell density <2200 cells/mm² and were considered as storage failure. Corneas with age 31 -40 years had significantly greater cell loss and poorer viability than those age over 70 (p=0.0189 and p=0.0076, respectively). There was strong correlation between final cell density and viability (r=0.773). Initial cell density was negatively related to the cell loss, while duration of storage was positively associated with cell loss (p=0.0005 and 0.0002 respectively).

Conclusions : The corneas from older donors have less endothelial cell loss and better viability during organ culture storage. The initial endothelial cell density and storage time have significant impact on final cell density and viability. The possible explanations may be due to slower metabolic processes in older corneas in organ culture and the potential mechanical protective effect of thicker Descemet’s membrane in older corneas.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.