Abstract
To evaluate factors affecting corneal endothelial cell density (ECD) under enucleation and preservation time studies at Eye Bank of the Federal District of Brazil. We conducted a case–control study collecting data from 1128 corneas where death-to-enucleation time and enucleation-to-preservation time were within 24 h. Low cell count were those corneas with an ECD less than 2000 cells/mm2 and high cell count was defined as those with ECD greater than 2000 cells/mm2. We calculated the independent risk factors related to: cause of death, donor age, death-to-enucleation time, enucleation-to-preservation time and primary graft failure. Correlation analysis was used to assess which parameters influence ECD: death-to-enucleation time, enucleation-to-preservation time, average cell area (AVE), coefficient of variation and percentage of hexagonal cells. Of the total number of corneas, 1004 had ECD data and were selected for the study. 87.4% (n = 877) had high cell counts with 2699 ± 412 cells/mm2. The mean donor age was 38.8 ± 16 years. The most common causes of death were external causes (48.6%, n = 488). Longer times from death-to-enucleation, up to 24 h were not associated with a decrease in ECD (OR 0.58; P = 0.44) or risk of graft survival (P = 0.74). Enucleation-to-preservation intervals greater than 12 h showed increased risk of graft survival (P = 0.04). AVE was the main parameter for ECD (R2 = 0.96, P < 0.001). The overall graft survival rate was 98.2% (n = 761). Donors with 40 years of age and above did not present a higher risk of graft survival (P = 0.09). We suggest that the maximum time from death-to-enucleation should be 24 h, assuming the body has been refrigerated after 6 h; and from enucleation-to-preservation time of 12 h, followed by proper processing and cornea morphology examination.
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Acknowledgements
The authors wish to thank all of our colleagues who worked on donor cornea procurement and preservation between 2014 and 2015. Thank as well go to all of the donors and their families, for without whom this study would not have been possible.
Funding
National Agency for Health Surveillance (ANVISA) and National Counsel for Scientific and Technological Development (CNPq) (Grants #440120/2014-4 and 440181/2014-3). The sponsor or funding organization had no role in the design or conduct of this research. This research was funded by the Brazilian National Council for Scientific and Technological Development (CNPq).
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Sampaio, T.L., Rodrigues, I.P., Cresta, M.B.L. et al. Factors influencing endothelial cell density of corneas for transplantation. Cell Tissue Bank 22, 263–275 (2021). https://doi.org/10.1007/s10561-020-09875-8
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DOI: https://doi.org/10.1007/s10561-020-09875-8