Abstract
Purpose :
To evaluate cornea donor demographics and determine the number of discarded donated corneas and the causes associated with discard in an eye bank in Southern Brazil.
Methods :
This retrospective, cross-sectional study analyzed the medical records of all cornea donations between January 2016 and December 2018 at the Londrina University Hospital Eye Bank. Variables analyzed included donor demographics, donor cause of death, enucleation time, endothelial assessment, tissue contamination, quality of the donated cornea and causes of discards.
Results :
A total of 1418 donor corneas were identified from 712 donors. Mean age of the donors was 53.54 ± 13.82 years, and 38.2% of the donors were over 60 years old. The main cause of donor death was cardiovascular or neurovascular disease (60.8%), followed by external causes of death (18%). Overall, 739 corneas (52.1%) were discarded. The main causes of discard were positive hepatitis B serology (35.1%), corneal tissue expiry date (28.9%) and corneal tissue contamination (12%). Acinetobacter baumannii and coagulase-negative Staphylococci were the most frequently isolated bacteria. The discard rate was significantly higher in the over 60 year-old donor age group compared to the 60 year-old and under age group (chi-square: p<0.001). In these groups, 64.4% and 44.5% of the donated corneas were discarded, respectively. Endothelial cell density (ECD) was found to be inversely correlated with the donor age (r: -0.435, p<0.001). The ECD average of the discarded corneas was of 2118 ± 452 cells/mm2, significantly lower than the average of 2492 ± 382 cells/mm2 found in the corneas that were utilized for transplantation (p<0.001). External causes of death had a higher ECD average when compared with cardiovascular or neurovascular diseases, respiratory system diseases and gastrointestinal diseases (p<0.001).
Conclusions :
A high corneal discard rate was observed in the present study, with positive serology, tissue expiry date and contamination being the main causes of discard. Discards were significantly more prevalent in older age groups (>60 years), and discarded corneas had lower endothelial cell density. The identification of significant trends in donor demographics could help with a more efficient assessment process of potential cornea donors in eye banks.
This is a 2021 ARVO Annual Meeting abstract.