Influencing factors on the suitability of organ-cultured corneas

To determine the factors related to donor and tissue retrieval, which influence the suitability of organ-cultured corneas for transplantation.

We retrospectively analysed 2596 donor corneas. Polytomic logistic regression analysis was used to assess the influence of various factors (that is, donor age, cause of death, death-to-tissue retrieval time, tissue retrieval-to-reception time, and tissue retrieval method) on the suitability of grafts for transplantation. Positive predictive values (PPVs) were computed.

Forty-three percent (1118/2596) of corneas were discarded. The leading cause for discarding corneas was poor endothelial quality (21.5%). Corneas from donors older than 80 years were more likely to be discarded because of endothelial insufficiency (OR=2.37, P=0.001). Longer time between death and tissue retrieval was associated with increased risk of positive serology (OR=1.43, P=0.02). Increased time between tissue retrieval and reception was associated with increased risk of contamination (OR=1.57, P=0.03). PPV increased from 38.5% for corneas retrieved from donors older than 80 years featuring a death-to-tissue retrieval time of more than 6 h and a tissue retrieval-to-reception time of more than 24 h to 64.7% for corneas retrieved from donors younger than 80 years featuring a death-to tissue retrieval time shorter than 6 h and a tissue retrieval-to-reception time shorter than 24 h.

The percentage of discarded corneas can be reduced by including donors aged 80 years or less, using a time from donor's death to tissue retrieval shorter than 6 h, and a tissue retrieval-to-reception time shorter than 24 h.