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How to Predict the Suitability for Corneal Donorship?
Franziska Schön1, Adrian Gericke1, Julia Bing Bu1
1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, 55131 Mainz, Germany.
Journal of Clinical Medicine
|August 7, 2021
Summary
Donor cornea usability is influenced by age, sex, and time since death. Even older donors and those collected later can be suitable for transplantation, suggesting broader acceptance criteria.
Area of Science:
- Ophthalmology
- Transplantation Science
- Corneal Research
Background:
- Over one-third of donor corneas in Germany are unsuitable for transplantation.
- Identifying factors affecting donor cornea usability is crucial for increasing transplant success rates.
Purpose of the Study:
- To evaluate factors influencing donor cornea usability.
- To determine the impact of donor characteristics on endothelial cell density (ECD).
Main Methods:
- Retrospective analysis of 2032 donor corneas from Rhineland-Palatinate Eye Bank.
- Investigated donor age, sex, lens status, cause of death, CPR, and death-to-explantation interval (DEI).
- Utilized a linear regression mixed model to analyze factors affecting ECD.
Main Results:
- Higher donor age, male gender, pseudophakic status, and longer DEI were associated with reduced ECD.
- Estimated cell loss was 7 cells/mm² per hour for DEI and 6 cells/mm² per year for age.
- Female donors had higher ECD than males; pseudophakic eyes had lower ECD than phakic eyes.
- Corneas from donors over 80 years or collected up to the third postmortem day remained suitable for transplantation.
Conclusions:
- Do not limit donor age or collection time to 24 hours.
- Excluding oncology donors is not recommended.
- Propose a mathematical model for improved donor preselection to meet the growing demand for donor corneas.
