1
|
Oseni J, Rand G, Moon JY, Gore P, Edwards B, Livesay T, Vizzerra A, Chuck RS. Effect of Head Trauma-Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors. Cornea 2023; 42:1211-1215. [PMID: 36730367 DOI: 10.1097/ico.0000000000003190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 09/26/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The purpose of this study was to examine the effect of head trauma-related deaths on corneal endothelial cell density (ECD) in eye bank donors. METHODS This is a retrospective study of 287 corneas from donors with causes of death secondary to motor vehicle accident with sustained head trauma (n = 50), gunshot wound to the head (n = 138), fall with sustained head trauma (n = 2), and non-head-related traumatic causes of death (n = 97). Donors older than age 50 years were excluded due to concern for undiagnosed Fuchs endothelial dystrophy as a potential confounder for the cause of endothelial cell loss. Donor characteristics, ECD, and focal endothelial cell loss on specular microscopy were compared between the groups. Donors in the head trauma and nonhead trauma groups were matched by age; there were 42 age-matched donors in both groups. RESULTS Age and ECD were negatively correlated (Pearson correlation coefficient = -0.57). Death-to-preservation time was not significantly different between the 2 groups ( P value = 0.59). The mean ECD in the head trauma group was 2859 ± 370 cells/mm 2 and 3041 ± 464 cells/mm 2 in the nonhead trauma group. The head trauma group had a lower ECD (178 ± 70 cells/mm 2 , P value = 0.013). After matching for age, the difference in ECD between the 2 groups was -94 ± 82 cells/mm 2 ( P value = 0.26). The adjusted odds of having focal endothelial cell loss was not statistically significant ( P value = 0.50) between the groups. CONCLUSIONS After statistical adjustments, there were no differences between the head trauma and nonhead trauma groups.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Roy S Chuck
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY
| |
Collapse
|
2
|
Musa M, Zeppieri M, Enaholo ES, Chukwuyem E, Salati C. An Overview of Corneal Transplantation in the Past Decade. Clin Pract 2023; 13:264-279. [PMID: 36826166 PMCID: PMC9955122 DOI: 10.3390/clinpract13010024] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
The cornea is a transparent avascular structure located in the front of the eye that refracts light entering the eyes and also serves as a barrier between the outside world and the internal contents of the eye. Like every other body part, the cornea may suffer insult from trauma, infection, and inflammation. In the case of trauma, a prior infection that left a scar, or conditions such as keratoconus that warrant the removal of all or part of the cornea (keratoplasty), it is important to use healthy donor corneal tissues and cells that can replace the damaged cornea. The types of cornea transplant techniques employed currently include: penetrating keratoplasty, endothelial keratoplasty (EK), and artificial cornea transplant. Postoperative failure acutely or after years can result after a cornea transplant and may require a repeat transplant. This minireview briefly examines the various types of corneal transplant methodologies, indications, contraindications, presurgical protocols, sources of cornea transplant material, wound healing after surgery complications, co-morbidities, and the effect of COVID-19 in corneal transplant surgery.
Collapse
Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
- Correspondence:
| | - Ehimare S. Enaholo
- Centre for Sight Africa, Nkpor, Onitsha 434112, Nigeria
- Africa Eye Laser Centre, Benin 300001, Nigeria
| | - Ekele Chukwuyem
- Centre for Sight Africa, Nkpor, Onitsha 434112, Nigeria
- Africa Eye Laser Centre, Benin 300001, Nigeria
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
| |
Collapse
|
3
|
Das AV, Kommu DR, Chilukuri R, Chilukuri H, Chaurasia S. Impact of the COVID-19 pandemic on the trends in corneal donor mortality data from Eye Bank records in India. Indian J Ophthalmol 2022; 70:3289-3293. [PMID: 36018105 PMCID: PMC9675537 DOI: 10.4103/ijo.ijo_778_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: To describe the causes and trends of corneal donor mortality from eye bank data in India during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This retrospective eye bank-based study included 13,529 donors who donated their cornea between January 2018 and December 2021. Donors in whom the cause of mortality was documented were included as cases. The data were collected from the eye bank records. Results: Overall, 13,529 corneal donors were included in the study. Most of the donors were males (69.71%). The mean age of the donors was 51.55 ± 20.54 years, whereas the median age was 51 (inter-quartile range: 35–68) years. The mean age of males (49.3 ± 19.47 years) was lesser than the mean age of females (56.72 ± 21.94 years) at the time of donation. The most common age group at the time of donation was during the sixth decade of life with 2,139 (15.81%) donors. The mean age of the donors decreased by a decade from 54.95 ± 20.51 years in 2018 to 44.35 ± 18.88 years in 2021. The most common cause of donor mortality was cardio-respiratory arrest in 5,190 (38.36%) donors and trauma in 3,469 (25.64%) donors, followed by suicide in 2,790 (20.62%) donors. The trend of cardio-respiratory arrest decreased from 53.01% to 9.5% (p = <0.00001), whereas the trends of trauma increased from 21.93% to 36% (p = <0.00001) and suicide increased from 12.71% to 36.41% (p = <0.00001) between 2018 and 2021. Conclusion: Corneal donors are more commonly males in their sixth decade of life. The most common cause of donor mortality was related to cardio-respiratory arrest with a concerning rising trend in suicide cases over the years seen significantly during the pandemic.
Collapse
Affiliation(s)
- Anthony Vipin Das
- Department of eyeSmart EMR and AEye; Indian Health Outcomes, Public Health and Economics Research Center, Hyderabad, Telangana, India
| | - Deepti Raj Kommu
- Department of Psychiatry, Bhaskar Medical College, Hyderabad, Telangana, India
| | | | - Harihar Chilukuri
- Department of Psychiatry, Bhaskar Medical College, Hyderabad, Telangana, India
| | - Sunita Chaurasia
- Cornea and Anterior Segment services; Ramayamma International Eye Bank, L V Prasad Eye Institute, Hyderabad, Telangana, India
| |
Collapse
|
4
|
How to Predict the Suitability for Corneal Donorship? J Clin Med 2021; 10:jcm10153426. [PMID: 34362207 PMCID: PMC8347780 DOI: 10.3390/jcm10153426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 01/24/2023] Open
Abstract
Background: In Germany, more than one-third of donor corneas harvested are not suitable for transplantation. We evaluated the factors associated with the usability of donor corneas. Method: Data from 2032 consecutive donor corneas harvested at the Rhineland-Palatinate Eye Bank in Mainz, Germany, were retrospectively analyzed. Factors of interest were age, sex, lens status, cause of death, cardiopulmonary resuscitation (CPR), death-to-explantation-interval (DEI), and the influence of these factors on the proportion of discarded donor corneas. Factors associated with endothelial cell density (ECD) were analyzed in a linear regression mixed model. Results: Higher donor age, male gender, pseudophakic lens status, and longer DEI were associated with significantly reduced ECD. With respect to DEI, the estimated cell loss was 7 ± 2 cells/mm2/hour (p < 0.001). Age was associated with a lower ECD of 6 ± 2 cells/mm2 per year (p = 0.001). Female ECD was 189 ± 44 cells/mm2 higher than male ECD (p < 0.001). Pseudophakic eyes had 378 ± 42 cells/mm2 less compared with phakic eyes (p < 0.001). Cause of death did not affect the ECD. Of note, 55% and 38% of corneas harvested on the second and third postmortem day, respectively, and 45% of corneas from donors older than 80 years were still suitable for transplantation. Conclusions: In the context of a growing need for donor corneas, we do not recommend limiting donor age and collection time to 24 h or excluding oncology donors, as is the practice in many countries. Therefore, we propose a mathematical model for better donor preselection.
Collapse
|
5
|
Sabater-Cruz N, Otero N, Dotti-Boada M, Ríos J, Gris O, Güell JL, Vilarrodona A, Casaroli-Marano RP. Eye bank and theatre factors for positive microbiological culture of corneoscleral rim and cornea storage medium in the real-world. Eye (Lond) 2021; 35:3087-3093. [PMID: 33469128 DOI: 10.1038/s41433-020-01342-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To evaluate microbiological culture rate and positivity of corneoscleral rim and cornea storage media as well as possible risk factors for contamination with real-world data. METHODS Data of consecutive cornea donors implanted in the reference centre from January 2013 to January 2018 were reviewed. Information about cornea characteristics (donor demographic data, endothelial cell density, type of cornea conservation, days of storage, and precut vs full-thickness tissue), and microbiological culture information (corneoscleral rim vs storage sample, positive result) were statistically analysed. RESULTS During the study period, 1369 corneas (737 donors) were implanted. Cultures were performed in 76.8% (n = 1052) of them and were positive in 3.2% of cases, mainly bacteria (84.4%). Corneas preserved in hypothermia represented 61.8% of all positive microbiology results (p < 0.001). Other analysed risk factors did not reach statistically significant association with microbiological positivity. None of the 34 cases with positive microbiological cultures reported ocular infection for the recipients in at least 6 months' follow-up. CONCLUSIONS Microbiological tests rate in real-world practice are high despite not being compulsory. Organotypic cultured corneas showed a statistically less positivity in corneoscleral and storage medium than hypothermic ones, resulting in another advantage of this kind of cornea storage. Although precut corneas are thought to present less microbiological positivity, a statistically significant association was not found in the present study.
Collapse
Affiliation(s)
- Noelia Sabater-Cruz
- Hospital Clinic de Barcelona, Barcelona, Spain. .,Department of Surgery, School of Medicine, University of Barcelona, Barcelona, Spain.
| | | | | | - José Ríos
- Hospital Clinic de Barcelona, Barcelona, Spain.,Medical Statistics Core Facility (IDIBAPS) and Biostatistics Unit, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Gris
- Instituto de Microcirugía Ocular (IMO), Barcelona, Spain
| | - José L Güell
- Instituto de Microcirugía Ocular (IMO), Barcelona, Spain
| | | | - Ricardo P Casaroli-Marano
- Hospital Clinic de Barcelona, Barcelona, Spain.,Department of Surgery, School of Medicine, University of Barcelona, Barcelona, Spain.,Barcelona Tissue Bank (BST-BTB), Barcelona, Spain
| |
Collapse
|
6
|
Hofmann N, Wittmershaus I, Salz AK, Börgel M. Cornea Procurement and Processing up to 72 Hours: No Risk for Cornea Transplant Quality. Transfus Med Hemother 2020; 48:3-11. [PMID: 33708047 DOI: 10.1159/000510588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/22/2020] [Indexed: 11/19/2022] Open
Abstract
Background The realization of tissue donations is bound to a tight timeframe. Depending on the type of tissue, time limits are specified within which the donation must be procured and processed. Otherwise, there is a risk of tissue quality loss with increasing time intervals from cardiovascular arrest. According to the European Directorate for the Quality of Medicines and HealthCare (EDQM) guide, cornea must be procured and processed within 72 h after death. The question arises whether this time interval has an influence on the quality of transplanted tissues and how it affects the accomplishment of tissue donations. Methods In order to obtain information on this, the numbers of tissue donations in the network of the German Society for Tissue Transplantation (DGFG) were evaluated as a function of the death to retrieval time (DRT) as well as the death to preservation time (DPT). For this purpose, 21,454 database entries of cornea donations made in the period from 2014 to 2018 were included. Results The results show that nearly 50% of donations realized in the DGFG network could be processed only 48 h or later after cardiovascular death due to the opt-in regulation in Germany. For these donations, there seems to be a higher discard rate compared to donations taken earlier. Nevertheless, there is a transplantation rate for these grafts of more than 65%, which is comparable to average transplantation rates stated in the literature. Conclusion All corneas finally selected for transplantation must meet the specified quality parameters. Since this naturally also applies to transplants that could only be procured at later time points, it can be concluded that DPT up to 72 h for corneal tissue is adequate and has no influence on the quality of corneas that are ultimately transplanted.
Collapse
Affiliation(s)
- Nicola Hofmann
- German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany
| | - Ilka Wittmershaus
- German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany
| | | | - Martin Börgel
- German Society for Tissue Transplantation (DGFG) gGmbH, Hannover, Germany
| |
Collapse
|
7
|
Ong HS, Peh G, Neo DJH, Ang HP, Adnan K, Nyein CL, Morales-Wong F, Bhogal M, Kocaba V, Mehta JS. A Novel Approach of Harvesting Viable Single Cells from Donor Corneal Endothelium for Cell-Injection Therapy. Cells 2020; 9:cells9061428. [PMID: 32526886 PMCID: PMC7349718 DOI: 10.3390/cells9061428] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/25/2020] [Accepted: 06/02/2020] [Indexed: 12/13/2022] Open
Abstract
Donor corneas with low endothelial cell densities (ECD) are deemed unsuitable for corneal endothelial transplantation. This study evaluated a two-step incubation and dissociation harvesting approach to isolate single corneal endothelial cells (CECs) from donor corneas for corneal endothelial cell-injection (CE-CI) therapy. To isolate CECs directly from donor corneas, optimization studies were performed where donor Descemet’s membrane/corneal endothelium (DM/CE) were peeled and incubated in either M4-F99 or M5-Endo media before enzymatic digestion. Morphometric analyses were performed on the isolated single cells. The functional capacities of these cells, isolated using the optimized simple non-cultured endothelial cells (SNEC) harvesting technique, for CE-CI therapy were investigated using a rabbit bullous keratopathy model. The two control groups were the positive controls, where rabbits received cultured CECs, and the negative controls, where rabbits received no CECs. Whilst it took longer for CECs to dislodge as single cells following donor DM/CE incubation in M5-Endo medium, CECs harvested were morphologically more homogenous and smaller compared to CECs obtained from DM/CE incubated in M4-F99 medium (p < 0.05). M5-Endo medium was hence selected as the DM/CE incubation medium prior to enzymatic digestion to harvest CECs for the in vivo cell-injection studies. Following SNEC injection, mean central corneal thickness (CCT) of rabbits increased to 802.9 ± 147.8 μm on day 1, gradually thinned, and remained clear with a CCT of 385.5 ± 38.6 μm at week 3. Recovery of corneas was comparable to rabbits receiving cultured CE-CI (p = 0.40, p = 0.17, and p = 0.08 at weeks 1, 2, and 3, respectively). Corneas that did not receive any cells remained significantly thicker compared to both SNEC injection and cultured CE-CI groups (p < 0.05). This study concluded that direct harvesting of single CECs from donor corneas for SNEC injection allows the utilization of donor corneas unsuitable for conventional endothelial transplantation.
Collapse
Affiliation(s)
- Hon Shing Ong
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
- Eye-Academic Clinical Program (ACP), Duke-National University of Singapore (NUS), Graduate Medical School, Singapore 169857, Singapore
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 168751, Singapore
- Correspondence: (H.S.O.); (J.S.M.); Tel.: +65-6227-7255 (H.S.O. & J.S.M.); Fax: +65-6227-7290 (H.S.O. & J.S.M.)
| | - Gary Peh
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
- Eye-Academic Clinical Program (ACP), Duke-National University of Singapore (NUS), Graduate Medical School, Singapore 169857, Singapore
| | - Dawn Jin Hui Neo
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
| | - Heng-Pei Ang
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
| | - Khadijah Adnan
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
| | - Chan Lwin Nyein
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
| | - Fernando Morales-Wong
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
| | - Maninder Bhogal
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
- Cornea Unit, Guy’s & St Thomas’ Hospital, London SE1 7EH, UK
| | - Viridiana Kocaba
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
- Netherlands Institute for Innovative Ocular Surgery, Melles Cornea Clinic, Amnitrans EyeBank Rotterdam, 3071 AA Rotterdam, The Netherlands
| | - Jodhbir S. Mehta
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore 169856, Singapore; (G.P.); (D.J.H.N.); (H.-P.A.); (K.A.); (C.L.N.); (F.M.-W.); (M.B.); (V.K.)
- Eye-Academic Clinical Program (ACP), Duke-National University of Singapore (NUS), Graduate Medical School, Singapore 169857, Singapore
- Corneal and External Diseases Department, Singapore National Eye Centre, Singapore 168751, Singapore
- School of Material Science and Engineering, Nanyang Technological University, Singapore 639798, Singapore
- Correspondence: (H.S.O.); (J.S.M.); Tel.: +65-6227-7255 (H.S.O. & J.S.M.); Fax: +65-6227-7290 (H.S.O. & J.S.M.)
| |
Collapse
|
8
|
Performance of New Hypothermic Corneal Storage Media With an Antimycotic Tablet in Comparison to Traditional Hypothermic Media During Simulated Eye Bank Processing. Cornea 2020; 39:1031-1039. [PMID: 32301814 DOI: 10.1097/ico.0000000000002333] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the performance of Kerasave (AL.CHI.MI.A. S.R.L., Ponte San Nicolò, Italy) containing 2.5 μg/mL of amphotericin B and Optisol-GS (Bausch & Lomb, Bridgewater, NJ) cold corneal storage media on donor corneas during routine eye bank procedures. METHODS Forty-four paired donor corneas were preserved after swab sample collection and povidone-iodine decontamination. Right and left corneas were immersed in Kerasave and Optisol-GS, respectively, and stored at 4°C before the initial evaluation. Paired corneas were assigned to processing subgroups for penetrating keratoplasty (n = 20), Descemet stripping automated endothelial keratoplasty (n = 14), or Descemet membrane endothelial keratoplasty (n = 10). Endothelial cell density, central corneal thickness, slit-lamp examination, and endothelial cell damage were assessed at different intervals. Sterility testing was performed on media samples. RESULTS At the initial evaluation, after 25.6 ± 3.2 hours of storage, the mean central corneal thickness of all corneas in Kerasave (n = 22) was greater than those in Optisol-GS (n = 22) (571 ± 12 μm vs. 526 ± 10 μm, respectively; P = 0.006). All other metrics were comparable between Kerasave and Optisol-GS in processing subgroups at all time intervals. Corneal swabs were positive in 90% of corneas before decontamination with povidone-iodine. At the initial evaluation, fungal contamination was detected in 24% and 19% of Kerasave and Optisol-GS, respectively. At the final evaluation, no fungi was detected in Kerasave and 1 Optisol-GS sample was positive (P = 0.999). CONCLUSIONS Metrics of corneas stored in Kerasave and Optisol-GS were comparable. Kerasave might be considered an antifungal-possessing alternative to Optisol-GS.
Collapse
|
9
|
Pessoa JLE, Schirmer J, Freitas DD, Knihs NDS, Roza BDA. Ocular tissue distribution in the State of São Paulo: analysis on corneal discarding reasons. Rev Lat Am Enfermagem 2019; 27:e3196. [PMID: 31618389 PMCID: PMC6792342 DOI: 10.1590/1518-8345.3041.3196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 06/18/2019] [Indexed: 11/22/2022] Open
Abstract
Objective to identify the reasons for refusal of corneas. Method this was a cross-sectional, retrospective, descriptive and correlational
study composed of 5,560 optical corneas. The information was taken from the
notification, organ procurement and distribution centers database as well as
donor records. Descriptive statistics were used for the analysis of
categorical variables and specific tests with a significance level of 5% for
assessing the associations between variables. This study met the ethical
aspects of scientific research. Results 60% of the donors were male and 40% died by circulatory problems. The main
reason for refusal as informed by transplant teams is the donor’s age and
the endothelial cell count. For each year added to the donor’s age, there is
a 1% decrease in the chance that this cornea will be used for
transplantation, and the increase of 100 cells per mm2 increases the chances
that this cornea will be used by 9%. Conclusion the main cause of refusal in the acceptance of corneal tissue is related to
the age and the endothelial cell count.
Collapse
Affiliation(s)
- João Luis Erbs Pessoa
- Secretaria de Saúde do Estado de São Paulo, Central de Transplantes, São Paulo, SP, Brasil
| | - Janine Schirmer
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, São Paulo, SP, Brasil
| | - Denise de Freitas
- Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brasil
| | | | | |
Collapse
|
10
|
Sharma N, Arora T, Singhal D, Maharana PK, Garg P, Nagpal R, Murthy S, Gunnam S, Arora A, Prajna V, Rajaraman R, Padmanabhan P, Kumar A, Kumar R, Tomar S, Thomas A, Gyanchand R, Arora R, Biswas B, Basak S. Procurement, storage and utilization trends of eye banks in India. Indian J Ophthalmol 2019; 67:1056-1059. [PMID: 31238409 PMCID: PMC6611250 DOI: 10.4103/ijo.ijo_1551_18] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose: To study the trends in collection, storage and utilization of donor corneas in eye banks in India. Methods: The data was collected from 12 eye banks in India that collected more than 1000 corneas per year. The retrospective analysis of the parameters like characteristics of the donor and the host, storage media used, number of eyes collected, number of eyes utilized, causes of non-utilization of the tissue and the procedures performed was done. Results: A total of 20,564 eyes were collected by the 12 eye banks during the year 2013–2014. Voluntary eye donation (VED), and hospital cornea retrieval program (HCRP) contributed to 59.6% and 40.4% of tissue procurement respectively. Whole globe enucleation (52.3%) was more commonly performed as compared to in-situ excision of the donor corneas. The most commonly used storage media at all eye banks was McCarey-Kaufman (MK) media (83.3%). The utilization rate of the donor eyes was 50.5%. The most frequent indication for corneal transplantation was infection (active infection - 33.13%, healed infection - 10.78%) followed by Pseudophakic bullous keratopathy (PBK) (13.57%). Full thickness keratoplasty (optical penetrating keratoplasty - 47.23%, therapeutic penetrating keratoplasty - 31.74%) was performed most often followed by endothelial keratoplasty (12.41%) in the developing country. Conclusion: VED still contributes to majority of the donor tissue retrieval in India. The majority of the eye banks still utilize whole globe enucleation technique and store tissues in MK media. Trends from previous years showed a change towards HCRP, in-situ excision technique and preservation in the long-term storage media.
Collapse
Affiliation(s)
- Namrata Sharma
- Department of Ophthalmology, National Eye Bank, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Tarun Arora
- Department of Ophthalmology, National Eye Bank, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Deepali Singhal
- Department of Ophthalmology, National Eye Bank, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prafulla K Maharana
- Department of Ophthalmology, National Eye Bank, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prashant Garg
- Department of Ophthalmology, Ramayamma International Eye Bank, LVPEI, Hyderabad, Telangana, India
| | - Ritu Nagpal
- Department of Ophthalmology, National Eye Bank, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Somasheila Murthy
- Department of Ophthalmology, Ramayamma International Eye Bank, LVPEI, Hyderabad, Telangana, India
| | - Srinivas Gunnam
- Department of Ophthalmology, Ramayamma International Eye Bank, LVPEI, Hyderabad, Telangana, India
| | - Aditya Arora
- Department of Ophthalmology, Pujyaniya Mata Kartar Kaur Ji Intl. Eye Bank, Sirsa, Haryana, India
| | | | | | - Prema Padmanabhan
- Department of Ophthalmology, C J Shah Cornea Services, Sankara Nethralaya, Chennai, India
| | - Arvind Kumar
- Department of Ophthalmology, Vasan Eye Bank, Coimbatore, Tamil Nadu, India
| | - Rajiv Kumar
- Department of Ophthalmology, Vasan Eye Bank, Coimbatore, Tamil Nadu, India
| | - Swati Tomar
- Department of Ophthalmology, Eye Bank Society of Rajasthan, Jaipur, Rajasthan, India
| | - Anila Thomas
- Department of Ophthalmology, Eye Bank Association, Angamally, Kerela, India
| | - Rekha Gyanchand
- Department of Ophthalmology, Lions International Eye Bank, Bangalore, India
| | - Ritu Arora
- Department of Ophthalmology, Eye Bank, Guru Nanak Eye Centre, Delhi, India
| | - Bani Biswas
- Department of Ophthalmology, Disha Eye Hospitals, Barrackpore, Kolkata, India
| | - Samar Basak
- Department of Ophthalmology, Disha Eye Hospitals, Barrackpore, Kolkata, India
| |
Collapse
|
11
|
A two-centre validation study of sterility test of corneal storage media with elimination of interfering antimicrobials in compliance with the European Pharmacopoeia. Cell Tissue Bank 2019; 20:275-285. [PMID: 31037539 DOI: 10.1007/s10561-019-09766-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 04/01/2019] [Indexed: 10/26/2022]
Abstract
The purpose of this study was to validate the sterility test of corneal culture and deswelling/transport media using a device for removal of antimicrobials before incubation in BACTEC™ automated system in two Italian Eye Banks. Corneal culture medium, TISSUE-C, and deswelling/transport medium, CARRY-C, were inoculated with 10-100 cfu of six European Pharmacopoeia (EP) reference strains and either treated with medical device RESEP for removal of antimicrobials (RESEP+ group) or left untreated (RESEP- group) before injection into the BACTEC Plus bottles. The same steps were repeated in the absence of inocula with tryptone soy broth samples as negative controls, and the inocula were also directly injected in the BACTEC™ bottles as growth controls. All the samples were incubated in BACTEC™ automated system for 7 days, and the time to detection of microbial growth was recorded automatically. At both the Eye Banks, in the RESEP+ groups, microbial growth was detected in 100% of samples. In the RESEP- group, the method sensitivity ranged from 66.7 ± 21.1 to 88.9 ± 6.4% for TISSUE-C samples while for CARRY-C samples the method sensitivity ranged from 94.5 ± 5.1 to 100%. The method specificity corresponded to 100% for all the groups at both Eye Banks. This two-centre validation study showed that the use of RESEP increased the sensitivity of sterility test using BACTEC™ automated system up to 100% and, consequently, allowed validation of the method for sterility testing of corneal storage and deswelling/transport media according to the EP requirements. The test could not be validated without the use of RESEP.
Collapse
|
12
|
Wenzel DA, Kunzmann BC, Druchkiv V, Hellwinkel O, Spitzer MS, Schultheiss M. Effects of Perfluorobutylpentane (F4H5) on Corneal Endothelial Cells. Curr Eye Res 2019; 44:823-831. [PMID: 30892089 DOI: 10.1080/02713683.2019.1597891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To evaluate the effects of perfluorobutylpentane (F4H5) on corneal endothelial cell density (ECD) and morphology using a porcine corneal endothelial organ culture model. Materials and methods: "Split corneal buttons" were cultivated for 15 days (d) after incubation in F4H5 (15, 30, 60, and 120 min) or BSS (controls). ECD was assessed manually on d1, d8, and d15. After histological staining (trypan blue, alizarin red S) on d15 morphological changes (reformation figures, rosette formations, and alizarin red cells) were evaluated. Results: ECD was significantly reduced after incubation in F4H5 for 120 min (median ± 25%/75%-quartile; 3281 ± 43/222 cells/mm2; p = 0.046) on d15 compared to controls (3658 ± 129/296 cells/mm2), but not after shorter incubation times (15, 30, and 60 min). Morphological assessment supports these findings as reformation figures (F4H5 120 min: 10.5 ± 9.3/13.9/mm2 vs. controls: 5.2 ± 2.8/7.2/mm2; p = 0.010), rosette formations (F4H5 120 min 25.566 ± 17.044/36.219/mm2 vs. controls: 8.333 ± 0.000/15.667/mm2; p = 0.002), and alizarin red cells (F4H5 120 min: 38.350 ± 29.827/51.333/mm2 vs. controls: 20.833 ± 10.417/25.000/mm2; p = 0.049) were significantly more prevalent after incubation in F4H5 for 120 min compared to controls. Also, F4H5 60 min showed significantly more rosette formations (25.452 ± 16.968/36.057/mm2; p = 0.006) and alizarin red cells (46.662 ± 42.420/50.903/mm2; p = 0.007), but not reformation figures (7.0 ± 2.2/1.6 %; p = 0.953). Conclusion: Short exposure (≤30 min) of porcine corneal endothelial cells to F4H5 does not have significant effects on ECD or morphological characteristics. Longer exposure times (≥60-120 min) may cause ECD decline and/or induce morphological changes.
Collapse
Affiliation(s)
- Daniel A Wenzel
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Berenike C Kunzmann
- b Center of Ophthalmology, University Eye Hospital Tübingen , Tübingen , Germany
| | - Vasyl Druchkiv
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Olaf Hellwinkel
- c Center for Diagnostics, Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Martin S Spitzer
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| | - Maximilian Schultheiss
- a Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE) , Hamburg , Germany
| |
Collapse
|
13
|
Vignola R, Giurgola L, Colabelli Gisoldi RAM, Gaudio M, D'Amato Tóthová J, Pocobelli A. Monitoring the microbial contamination of donor cornea during all preservation phases: A prospective study in the Eye Bank of Rome. Transpl Infect Dis 2018; 21:e13041. [PMID: 30582780 DOI: 10.1111/tid.13041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 12/06/2018] [Accepted: 12/16/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND In most European eye banks, human donor corneas are microbiologically tested after storage in organ culture conditions, and the tissues that are free of contamination are distributed for transplantation. In this prospective study, 100 donor corneas were tested for microbial contamination after cold storage, corneal culture and corneal deswelling at the Eye Bank of Rome. METHODS Samples of cold storage medium (EUSOL-C), corneal culture medium (TISSUE-C) and deswelling medium (CARRY-C) were tested after three, seven and one days of corneal storage, respectively. The CARRY-C medium, used to transport the cornea to the operation theatre, was retested 1 day after transplantation. The TISSUE-C and CARRY-C media were also tested after removing antimicrobial and antifungal agents using a dedicated device. RESULTS We found 67% of the EUSOL-C samples were contaminated mainly by Staphylococcus spp, 14% of TISSUE-C media were contaminated by bacteria and fungi and 3% of CARRY-C media by Staphylococcus spp The analysis performed after removing the antimicrobial and antifungal agents showed growth in three additional TISSUE-C samples (S viridans, S haemolyticus and E faecalis) and one CARRY-C (S cerevisiae and P acnes). CONCLUSION Tissue contamination was unexpectedly high on arrival to the eye bank, indicating the need to review and update decontamination procedures during tissue recovery, and renew training for the recovery teams. Storing donor corneas in organ culture conditions significantly reduced the microorganism burden. Using devices to remove antimicrobial and antifungal agents from samples before testing can increase the sensitivity of the standard microbiological method, and thus help further reduce the risk of microbial transmission.
Collapse
Affiliation(s)
- Rossella Vignola
- Eye Bank of Rome, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | | | - Mariarosa Gaudio
- Clinical Pathology, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| | | | - Augusto Pocobelli
- Eye Bank of Rome, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
| |
Collapse
|
14
|
Establishment of a porcine corneal endothelial organ culture model for research purposes. Cell Tissue Bank 2017; 19:269-276. [DOI: 10.1007/s10561-017-9669-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
|
15
|
Filev F, Hellwinkel OJC, Eddy MT, Linke SJ, Wulff B. Endothelial Cell Count in Eye Bank Corneal Grafts: Impact of Death Cause and Donor Diseases. Semin Ophthalmol 2016; 33:338-344. [PMID: 27960577 DOI: 10.1080/08820538.2016.1238100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this study is to analyze the impact of death causes and documented donor diseases on initial endothelial cell counts (after retrieval) and the development of corneal graft endothelia during organ culture. METHODS The retrospective statistic analyses was conducted on a data set of 10,185 human corneas prepared at the Hamburg Eye Bank. RESULTS Although we observed that death by gunshot trauma or alcoholism seems to be associated with marginally higher endothelium cell counts (independently from donor age), we could prove that only donor age is a relevant predictive parameter for the initial cell-density of the endothelium and its development in vitro. CONCLUSION We conclude that an extension of prospective quality parameters for donor selection additional to donor age (such as individual causes of death) is not necessary.
Collapse
Affiliation(s)
- Filip Filev
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Olaf J C Hellwinkel
- b Department of Forensic Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | | | - Stephan J Linke
- a Department of Ophthalmology , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Birgit Wulff
- b Department of Forensic Medicine , University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| |
Collapse
|
16
|
Suitability of Corneal Tissue for Transplantation Derived From Violent Death: A 10-Year Analysis. Transplant Proc 2016; 47:2973-7. [PMID: 26707324 DOI: 10.1016/j.transproceed.2015.07.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 07/14/2015] [Indexed: 11/20/2022]
Abstract
Trauma is a leading cause of death and disability worldwide. Corneal tissue donors generally are those who suffered an injury to the brain or fatal trauma caused by stroke, vehicle/motorbike accidents, gunshot wounds, and drowning or cardiovascular death. In Brazil, the Distrito Federal (DF) Eye Bank, located within a trauma center hospital, and the Secretariat of Public Security have collaborated with the aim of increasing the overall number of cornea donations from fatal trauma victims. The purpose of this study was to determine the suitability of cornea tissue for transplantation derived from trauma-related death. The records of eyes donated in the DF Eye Bank were analyzed retrospectively for the period from 2004-2013. We had 3388 cornea donors, the majority of which were between 21 and 30 years old (17.4%), which were derived from violent death (84.1%; P = .00) and were predominately male (73.5%). Among the donated corneas, 54.0% were used for optic purposes. Mechanical trauma caused by gunshot, stabbing or blunt force (23.7%), and road traffic injuries (11%) were the main causes of violent death. Another common cause of death was cardiovascular disease (26.3%). Donor tissue derived from violent death had no statistical interference on tissue suitability for transplantation (P = .06). Because of the large waiting lists, and waiting times for transplants, it is advisable to increase the available tissue from corneas donors derived from violent death through the implementation of this interagency model of collaboration and by the practicing of active tissue donor screening in trauma center hospitals.
Collapse
|
17
|
Victer TNDF, Dos Santos CSR, Báo SN, Sampaio TL. Deceased tissue donor serology and molecular testing for HIV, hepatitis B and hepatitis C viruses: a lack of cadaveric validated tests. Cell Tissue Bank 2016; 17:543-553. [PMID: 27329292 DOI: 10.1007/s10561-016-9564-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/06/2016] [Indexed: 01/13/2023]
Abstract
Vital to patient safety is the accurate assessment and minimization of risk for human immunodeficiency virus (HIV), Hepatitis C (HCV), and Hepatitis B (HBV) virus transmission by deceased donor organ and tissue transplantation. The pathogens are tested by serological kits based on enzyme-linked immunosorbent assay (ELISA), chemiluminescence (CLIA) and eletrochemiluminescence (ECLIA) immunoassays. Organ transplantation is a highly successful life-saving treatment in Brazil, but the Brazilian Health Surveillance Agency currently mandates that all deceased organ donors are screened for HIV, HCV and HBV following living donor policies. In this review, six ELISA (Wama®, Bio-Rad®, Biomerieux®, DiaSorin®, Acon Biotech® and Biokit®), three CLIA (Abbott®, Siemens®, Diasorin®) and one ECLIA (Roche®) were utilized for evaluating the effectiveness of those serological tests for deceased donors in Brazil according to manufacturer's guidelines. NAT for HIV, HCV and HBV can assist with detection of pre-seroconversion for those infections, and only Cobas® TaqScreen MPX® test, the Tigris System® Procleix Ultrio Assay® and the Bio-Manguinhos® HIV/HCV/HBV NAT are commercially available. Between all the tests, only the manufacturer Abbott® and Cobas® TaqScreen MPX® test are currently validated for cadaver samples.
Collapse
Affiliation(s)
| | | | - Sônia Nair Báo
- Department of Cell Biology, University of Brasília, Brasília, 70919-970, Brazil
| | - Thatiane Lima Sampaio
- Department of Cell Biology, University of Brasília, Brasília, 70919-970, Brazil. .,Federal Institute of Brasília, Brasília, 73380-900, Brazil.
| |
Collapse
|
18
|
Implementation of Organ Culture storage of donor corneas: a 3 year study of its impact on the corneal transplant wait list at the Lions New South Wales Eye Bank. Cell Tissue Bank 2016; 17:377-85. [DOI: 10.1007/s10561-016-9557-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
|
19
|
Yuksel E, Yuksel N, Akata F. Comparison of two in situ corneal donation technique: morgue trephination or scleracorneal removal technique. Acta Ophthalmol 2015; 93:e573-7. [PMID: 25913383 DOI: 10.1111/aos.12692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 01/12/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare the two different 'in situ' methods of corneal trephination technique under morgue condition (morgue trephination technique, MTT) and classic scleracorneal removal technique (SRT). METHODS A total of 1179 cases were evaluated for cornea donation at Gazi University Faculty of Medicine mortuary between the years 2008 and 2013 and were included to the study. Suitable donor corneas were retrieved with in situ trephination technique under morgue condition (group 1, MTT) or with in situ classic SRT (group 2, SRT). The two different 'in situ' methods were compared in terms of donor corneal biological quality (endothelial cell count, ECC) and functional outcome (presence of infection and primary graft failure). RESULTS One hundred and fifty-two of 1179 cases were suitable for corneal donation. Two hundred and twenty-nine corneas of 152 cases were transplanted, 108 corneas were obtained with MTT and 121 corneas were obtained with SRT. Pretransplant and post-transplant ECCs were 2402.5 ± 115.6 and 2108.3 ± 108.23 (p = 0.065) in MTT, respectively, and 2512.7 ± 130.4 and 2235.4 ± 201.8 (p = 0.059) in SRT, respectively. The incidence of primary graft failure and infection was not statistically significantly different between two method [2.7% and 1.6% (p = 0.223), 0.9% and 0.8% (p = 0.115)]. CONCLUSION The two different 'in situ' methods, MTT and SRT, were similar in terms of donor ECC, presence of infection and primary graft failure. Cornea excision performed through the technique described herein may increase the corneal donation rates as result of reduced disfigurement to donor body and offer important contributions during surgery with good anatomic adaptation of tissues.
Collapse
Affiliation(s)
- Erdem Yuksel
- Deparment of Ophthalmology; Faculty of Medicine; Gazi University; Ankara Turkey
| | - Nilay Yuksel
- Ophthalmology Clinic; Ataturk Training and Research Hospital; Ankara Turkey
| | - Fikret Akata
- Deparment of Ophthalmology; Faculty of Medicine; Gazi University; Ankara Turkey
| |
Collapse
|
20
|
Ghouali W, Grieve K, Bellefqih S, Sandali O, Harms F, Laroche L, Paques M, Borderie V. Full-Field Optical Coherence Tomography of Human Donor and Pathological Corneas. Curr Eye Res 2014; 40:526-34. [DOI: 10.3109/02713683.2014.935444] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|