Adequacy of the ELISA test for screening corneal transplant donors

Using a simple mathematical model, we calculated the risk for a patient undergoing penetrating keratoplasty to receive a cornea from a human immunodeficiency virus-infected donor despite negative results on serologic testing of donor serum. This error in serologic testing occurred when false-negative results were obtained from the enzyme-linked immunosorbent assay used to screen donor corneas for human immunodeficiency virus exposure. The average risk of transplanting an infected cornea was low, 0.03%, but increased by a factor of ten when donor tissue from donors at high risk for AIDS was used. Current screening procedures are probably adequate to prevent transmission of human immunodeficiency virus, but increased vigilance for high-risk donor populations may be appropriate.