Comparative infectious serology testing of pre- and post-mortem blood samples from cornea donors
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Defined serological blood tests of deceased cornea donors are required to minimize the risk of viral infections of a transplant recipient as much as possible. Haemolysis, autolysis and bacterial contamination, may produce significant changes of post-mortem blood samples, which may lead to false serological test results. Pre- and post-mortem findings from the same cornea donors of the University Tissue Bank of the Charité in the years 2004–2009 (n = 487) were retrospectively analyzed and compared. The test results from pre-mortem blood samples were defined as the reference for the post-mortem blood test. Of 487 cornea donors, there were a total of 21 cases (4.3 %) with discrepancies between serological test results from pre- and post-mortem blood samples. Of these, 7 values referred to the HBsAg-testing, 3 to the anti-HBs-, 1 to the anti-HBcIgG + IgM-, 1 to the anti-HCV-, 4 to the anti-HIV 1/2- and 5 to the TPLA-findings. False negative results within post-mortem serology occurred in 4 of 487 cases (0.8 %). False positive results within the post-mortem blood samples occurred at a much more frequent rate, with 17 of 487 cases (3.5 %). Discrepancies between serological pre- and post-mortem blood tests occur mainly due to the use of non-validated test systems. Therefore, it seems reasonable to test pre- and post-mortem blood samples serologically, whenever possible, at the same time, regardless of the sample age. Positive results, regardless of the sample type, should always be retested with validated confirmation tests (e.g. NAT), in order to differentiate between false and true positive results.
KeywordsCornea donor Serology Post-mortem blood sample
The authors thank Susanne Katz and colleagues of the Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry of the Charité for technical assistance and the retrospective listing of all relevant blood findings for the study. The authors thank Karin Jakstadt and Lutz Schmidt of the Institute of Transfusion Medicine of the Charité for technical assistance in the implementation of the experiments.
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