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Factors that influence the suitability of human organ-cultured corneas

  • Cornea
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Abstract

Purpose

The purpose was to assess the influence of donor and storage factors on the suitability of organ-cultured corneas for transplantation.

Methods

Data from 1340 donor corneas stored between 2009 and 2015 were analyzed retrospectively. Logistic regression analysis was used to assess the influence of different factors on the suitability of grafts for transplantation.

Results

Forty-one percent (553/1340) of corneas were discarded. The leading causes were medical contraindication (20.2 %) and poor endothelial quality (19.3 %). Donor age influenced suitability for transplantation significantly. Corneas from donors aged 80 years and older were more likely to be discarded because of endothelial insufficiency (P < 0.0001). The cause of donor death including infection and multiple organ dsyfunction syndrom (MODS) increased the risk of bacterial or fungal contamination during organ culture (P = 0.007 and P = 0.014, respectively). Prolonged time between death and enucleation was associated with an increased risk of unsuitability for transplantation (P < 0.0001). The amount of time between death and corneoscleral disc excision and duration of storage influenced the suitability for transplantation (P = 0.0007 and P < 0.0001, respectively).

Conclusion

Donor age, cause of death, storage time, death to enucleation and death to disc excision times influenced transplantation suitability. The percentage of discarded corneas may be reduced by shortening storage time, death to enucleation, and death to corneoscleral disc excision times. Setting a maximum donor age could reduce the percentage of discarded corneas. However, as long as there is a lack of donor corneas, we do not recommend any donor age limit.

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References

  1. EEBA (2006) European Eye Bank Association Directory. 14th ed, Amsterdam, The Netherlands. Page 12

  2. EEBA (2007) European Eye Bank Association Directory. 15th ed, Amsterdam, The Netherlands. Page 15

  3. Summerlin WT, Miller GE, Harris JE, Good RA (1973) The organ-cultured cornea: an in vitro study. Invest Ophthalmol 12:176–180

    PubMed  CAS  Google Scholar 

  4. Doughman DJ, Van Horn D, Rodman WP, Byrnes P, Lindstrom RL (1976) Human corneal endothelial layer repair during organ culture. Arch Ophthalmol 94:1791–1796

    Article  PubMed  CAS  Google Scholar 

  5. McCarey BE, Kaufman HE (1974) Improved corneal storage. Invest Ophthalmol 13:165–173

    PubMed  CAS  Google Scholar 

  6. Pels L (1997) Organ culture: the method of choice for preservation of human donor corneas. Br J Ophthalmol 81:523–525

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  7. Thuret G, Carricajo A, Vautrin AC, Raberin H, Acquart S, Garraud O, Gain P, Aubert G (2005) Efficiency of blood culture bottles for the fungal sterility testing of corneal organ culture media. Br J Ophthalmol 89:586–590

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  8. Gavrilov JC, Borderie VM, Laroche L, Delbosc B (2010) Influencing factors on the suitability of organ-cultured corneas. Eye 24:1227–1233

    Article  PubMed  Google Scholar 

  9. Yoeruek E, Bartz Schmidt K (2015) Current Approaches to Combat the Shortage of Corneal Tissues: Split-DMEK and Double-Split Keratoplasty. Cornea 34(3):e6–9. doi:10.1097/ICO.0000000000000341

    Article  PubMed  Google Scholar 

  10. Armitage WJ, Easty DL (1997) Factors influencing the suitability of organ-cultured corneas for transplantation. Invest Ophthalmol Vis Sci 38:16–24

    PubMed  CAS  Google Scholar 

  11. Armitage WJ, Jones MN, Zambrano I, Carley F, Tole DM (2014) The suitability of corneas stored by organ culture for penetrating keratoplasty and influence of donor and recipient factors on 5-year graft survival. Invest Ophthalmol Vis Sci 55:784–791

    Article  PubMed  Google Scholar 

  12. Thuret G, Manissolle C, Acquart S, Le Petit JC, Maugery J, Campos-Guyotat L, Doughty MJ, Gain P (2003) Is manual counting of corneal endothelial cell density in eye banks still acceptable? The French experience. Br J Ophthalmol 87:1481–1486

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  13. Heindl LM, Riss S, Bachmann BO, Laaser K, Kruse FE, Cursiefen C (2011) Split cornea transplantation for 2 recipients: a new strategy to reduce corneal tissue cost and shortage. Ophthalmology 118:294–301

    Article  PubMed  Google Scholar 

  14. Eye Bank Association of America (2013) Eye Banking Statistical Report. http://www.restoresight.org/wp-content/uploads/2014/04/2013_Statistical_Report-FINAL.pdf. Accessed 12 June 2015

  15. Rein DB, Zhang P, Wirth KE, Lee PP, Hoerger TJ, McCall N, Klein R, Tielsch JM, Vijan S, Saaddine J (2006) The economic burden of major adult visual disorders in the United States. Arch Ophthalmol 124:1754–1760

    Article  PubMed  Google Scholar 

  16. Javitt JC, Zhou Z, Willke RJ (2007) Association between vision loss and higher medical care costs in Medicare beneficiaries costs are greater for those with progressive vision loss. Ophthalmology 114:238–245

    Article  PubMed  Google Scholar 

  17. Frick KD, Gower EW, Kempen JH, Wolff JL (2007) Economic impact of visual impairment and blindness in the United States. Arch Ophthalmol 125:544–550

    Article  PubMed  Google Scholar 

  18. Haymes SA, Johnston AW, Heyes AD (2002) Relationship between vision impairment and ability to perform activities of daily living. Ophthalmic Physiol Opt 22:79–91

    Article  PubMed  Google Scholar 

  19. Kuyk T, Liu L, Elliott JL, Grubbs HE, Owsley C, McGwin G Jr, Griffin RL, Fuhr PS (2008) Health-related quality of life following blind rehabilitation. Qual Life Res 17:497–507

    Article  PubMed  PubMed Central  Google Scholar 

  20. van der Aa HP, Comijs HC, Penninx BW, van Rens GH, van Nispen RM (2015) Major depressive and anxiety disorders in visually impaired older adults. Invest Ophthalmol Vis Sci 56:849–854

    Article  PubMed  Google Scholar 

  21. Kwartz J, Leatherbarrow B, Dyer P, Ridgway AE, Tullo AB (1995) Penetrating keratoplasty for pseudophakic corneal oedema. Br J Ophthalmol 79:435–438

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  22. Eye Bank Association of America (2013) Cost-Benefit Analysis of Corneal Transplant http://www.restoresight.org/wp-content/uploads/2013/10/Lewin-Study-Executive-Summary-pdf. Accessed 2 April 2015

  23. Bourne WM, Nelson LR, Hodge DO (1997) Central corneal endothelial cell changes over a ten-year period. Invest Ophthalmol Vis Sci 38:779–782

    PubMed  CAS  Google Scholar 

  24. Campolmi N, He Z, Acquart S, Trone MC, Bernard A, Gauthier AS, Garraud O, Forest F, Péocʼh M, Gain P, Thuret G (2014) Comparison of endothelial cell density of organ cultured corneas with cornea donor study. Cornea 33:597–603

    Article  PubMed  Google Scholar 

  25. Robert PY, Camezind P, Drouet M, Ploy MC, Adenis JP (2002) Internal and external contamination of donor corneas before in situ excision: bacterial risk factors in 93 donors. Graefes Arch Clin Exp Ophthalmol 240:265–270

    Article  PubMed  Google Scholar 

  26. Spelsberg H, Reinhard T, Sengler U, Daeubener W, Sundmacher R (2002) Organ-cultured corneal grafts from septic donors: a retrospective study. Eye (Lond) 16:622–627

    Article  CAS  Google Scholar 

  27. Böhringer D, Reinhard T, Spelsberg H, Sundmacher R (2002) Influencing factors on chronic endothelial cell loss characterised in a homogeneous group of patients. Br J Ophthalmol 86:35–38

    Article  PubMed  PubMed Central  Google Scholar 

  28. Rijneveld WJ, Wolff R, Völker-Dieben HJ, Pels E (2010) Validation of tissue quality parameters for donor corneas designated for emergency use in preservation of the globe. Cornea 29:128–132

    Article  PubMed  Google Scholar 

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Conflict of interests

None. No support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Funding statement

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany

    T. Röck, J. Hofmann, S. Thaler, K. U. Bartz-Schmidt, E. Yoeruek & D. Röck

  2. Department of General Medicine, Ruhr-University Bochum, Bochum, Germany

    M. Bramkamp

Authors
  1. T. Röck
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  2. J. Hofmann
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  3. S. Thaler
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  4. M. Bramkamp
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  5. K. U. Bartz-Schmidt
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  6. E. Yoeruek
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  7. D. Röck
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Correspondence to T. Röck.

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Röck, T., Hofmann, J., Thaler, S. et al. Factors that influence the suitability of human organ-cultured corneas. Graefes Arch Clin Exp Ophthalmol 254, 135–141 (2016). https://doi.org/10.1007/s00417-015-3119-7

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  • DOI: https://doi.org/10.1007/s00417-015-3119-7

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