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Patrick Gore, Gabriel M Rand, Isaac Marco Chocron, Lynn Forest-Smith, Tina Livesay, Sruti Akella, Roy S Chuck; Mechanical ventilation in eye bank donors is associated with poorer corneal transplant suitability. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3887.
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Although many organ donors are on mechanical ventilation at the time of death and and mechanical ventilation is a known risk factor for ocular surface disease, surprisingly little is known about the effect it has has on tissue transplant suitability. We performed a retrospective analysis to determine if mechanical ventilation is a risk factor for poorer tissue suitability.
De-identified cornea donor data was supplied from Saving Sight of Kansas City, Missouri (2011-2015). The data set contained information on 13,659 donated corneas including donor demographics, time from death to preservation of the cornea, days on mechanical ventilation, and suitability for transplantation. Primary outcomes were epithelial and stromal suitability for transplant based on slit lamp tissue analysis.
Among 7,962 donors (mean [SD] age, 57.3 [14.8] years; 4,742 men and 3,220 women), the percent of unsuitable corneas due to epithelial sloughing and stromal keratitis was 0.1% and 3.4% respectively. After adjusting for time from death to preservation, donors on more than 2 days of mechanical ventilation were associated with increased odds of stromal keratitis (adjusted odds ratio, 5.86; 95% CI, 4.84-7.11; P < .001). There was no association between mechanical ventilation and epithelial sloughing (adjusted odds ratio, 0.00; P = 0.986).
The analysis demonstrated that mechanical ventilation is a risk factor for unsuitable corneas due to stromal keratitis. We recommend working together with the intensive care community to help improve suitability of tissues prior to eye bank procurement.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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