Examining the Impact of Corneal Tissue Transnational Activity, and Transplantation, on Import and Export Nations: A Review of the Literature

Heather Machin ^1,2,3, Janan Arslan ^2,3, Paul N Baird ³

⁰Lions Eye Donation Service, Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.

Cornea +

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January 16, 2020

View abstract on PubMed

Summary

Transnational activity (TNA) of corneal tissue (CT) is crucial for transplantation, yet its impact on import and export nations is under-reported. Further research is needed to address clinical and nonclinical aspects of CT TNA.

Area Of Science

Ophthalmology
Transplantation Science
Global Health

Background

Corneal transplantation is vital, with 12.7 million individuals globally awaiting the procedure.
Over half of those awaiting transplants lack access to domestic corneal tissue (CT) and rely on transnational activity (TNA).
CT TNA, initiated in 1961, lacks comprehensive impact assessments on involved nations.

Purpose Of The Study

To evaluate the impact of clinical and nonclinical CT TNA on both importing and exporting countries.
To prioritize the examination of nonclinical aspects to inform future practices.
To contextualize CT TNA within historical and global frameworks.

Main Methods

A systematic review of the academic literature was conducted using various search engines.
The review focused on both clinical and nonclinical facets of CT TNA.
Historical and global contexts were established for the review.

Main Results

Only 14 studies (11 clinical, 3 nonclinical) on CT TNA were found, published between 1991 and 2018.
Clinical studies highlighted factors like preservation times, logistics, donor/recipient selection, and tissue quality.
Nonclinical studies identified emerging themes in financial, ethical, and sustainability aspects of TNA.

Conclusions

There is a significant under-reporting of all CT TNA aspects, hindering comprehensive impact analysis.
Imported CT is considered comparable to domestic CT, offering a viable option when domestic supply is insufficient, despite risks like endothelial cell loss.
Crucial nonclinical elements, including ethical, equitable, and economic considerations, remain inadequately addressed.

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