June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
The Updated 2023 Protocol for Reviving In Vivo-like ERG A- and B-waves in Ex Vivo Human Organ Donor Eyes.
Author Affiliations & Notes
  • Anne M Hanneken
    Scripps Research Institute Department of Molecular and Experimental Medicine, La Jolla, California, United States
    Retina Consultants San Diego, Poway, California, United States
  • Lisa Stocks
    LifeSharing - A Donate Life Organization, San Diego, California, United States
  • Satchidananda Panda
    Salk Institute for Biological Studies, La Jolla, California, United States
  • Frans Vinberg
    University of Utah Health John A Moran Eye Center, Salt Lake City, Utah, United States
  • Footnotes
    Commercial Relationships   Anne Hanneken None; Lisa Stocks None; Satchidananda Panda None; Frans Vinberg None
  • Footnotes
    Support  AH is supported by NIH/NCATS grant UL1 TR002550, NIH EY026651, the Warren Family Foundation, the Paul Emple Foundation and additional philanthropic funding. FV is supported by NIH grant EY026651, Research to Prevent Blindness / Dr. H. James and Carole Free Career Development Award, Diabetes Research Connection and International Retinal Research Foundation. The authors also acknowledge support from an RPB unrestricted grant to the Department of Ophthalmology at the University of Utah.
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 5414. doi:
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      Anne M Hanneken, Lisa Stocks, Satchidananda Panda, Frans Vinberg; The Updated 2023 Protocol for Reviving In Vivo-like ERG A- and B-waves in Ex Vivo Human Organ Donor Eyes.. Invest. Ophthalmol. Vis. Sci. 2023;64(8):5414.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : We established a method for the revival of in vivo-like ERG a- and b-waves in postmortem ex vivo human organ donor retina (Nature 2022). We aim to share our strategies for building the organizational infrastructure necessary to achieve these goals and present our updated 2023 protocol.

Methods : The successful revival of in vivo-like ERG a- and b-waves from the human macula involved a coordinated effort with administrative, surgical and scientific personnel. The critical infrastructure was organized by a chief executive who served as a liaison between the organ procurement organization (OPO), the contracted eye bank, and the surgical and research teams. The Liaison convinced representatives at each organization to commit to a shared focus, established appropriate lines of communication and accountability, and streamlined the recovery process. Our 2023 protocol outlines the new criteria for reviving light signaling in the human retina and includes a preoperative bedside electroretinogram (ERG) and funduscopic examination which eliminates the recovery of donor eyes with ischemic damage.

Results : Roadblocks limiting access to organ donor eyes were overcome by the Liaison who built a consensus with the directors at each organization, educated the staff online, monitored the OPO board using Digital Donor software and coordinated the recoveries with the ophthalmologist and the research teams. Roadblocks to funding the eye bank were offset by a local foundation. Iatrogenic damage to ocular tissues was avoided by an experienced ophthalmic surgeon. Ischemic ocular tissue was identified during a preoperative bedside funduscopic examination and in vivo ERG. Significant 60 Hertz electronic ERG interference was observed in patients on ventilators, monitors and pumps but was minimized with adjustments. Revival of in vivo-like ERG waves from organ donor eyes was optimized with a 20-minute recovery following circulatory death and re-oxygenation in Ames media. Retinal punches were taken from the macula and periphery and placed in a custom ex vivo ERG device to measure light-induced electrical responses (c/o Frans Vinberg) or used for MEA recordings of retinal ganglion cells (c/o Satchin Panda).

Conclusions : This updated 2023 protocol and organizational infrastructure has been a key element in accessing and reviving human organ donor eyes for the study of aging, retinal diseases and visual rehabilitation.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

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