[Cornea donation: role of the local coordinator in monitoring and implementation]

In order to contribute to the dissemination of an organ and tissue donation culture, the authors report the results of a retrospective investigation into the donation of corneas for transplantation relative to the period from January 1997 to December 2001 at a leading hospital in the Milan area.

All cases of intra-hospital death (n=2137) were considered. The adoption of a selection protocol for potential donors, in accordance with the indications of the North Italy Transplant program, and constant monitoring on the part of the local coordinator, led to the collection of 348 corneal flaps using the procedure whereby all deaths have to be notified to the Health Department.

Over this period, the donors/deaths ratio increased from 2.1 to 17.6%, while the collection index (real donors/potential donors including those wrongly excluded) increased from 40.8% in 1999-2000 to 67.8% in 2001. Most involved in the donor selection activity were the intensive care centres with an increase for Resuscitation of 12.7% and for First Aid of 33%, to a lesser extent non-intensive centres (increase of 11.2%). The causes of exclusion from cornea collection in the last three-year period were clinical contraindications in 51.2% of cases (sepsis, blood transfusions, diseases of the central nervous system of unknown aetiology), failure to activate the procedures in 17.4% of cases, opposition in 17%, unsuitability of the corneal tissues in 11.3%, inadequate age in 3%.

The results obtained indicate good prospects for technical implementation and for the development of a donation culture in respect of other organs and tissues.