Enhancing Corneal Donation Through Hospital Collaborations in Germany: A 21-Year Perspective

Area of Science:

• Ophthalmology
• Transplantation Science
• Public Health

Background:

• Corneal transplantation (keratoplasty) is a common procedure globally.
• Shortages in donor eye tissue persist, impacting patient access to sight-restoring surgery.
• External hospital collaborations are a strategy to augment corneal donation.

Purpose of the Study:

• To evaluate the impact of external hospital collaborations on corneal donation rates.
• To analyze donor demographics and tissue quality from external versus internal sources.
• To identify operational barriers hindering optimal corneal procurement.

Main Methods:

• Retrospective analysis of 7054 corneal donors (2004-2024) from an eye bank.
• Comparison of donation rates, donor characteristics, and tissue quality (endothelial cell density).
• Logistic regression for transplantation likelihood; questionnaire for staff-assessed collaboration and efficiency.

Main Results:

• External donations increased over 20 years, contributing 35.3% of donors.
• External donors had shorter death-to-retrieval times but lower endothelial cell density.
• Staff reported good collaboration but longer assessment times for external donors.

Conclusions:

• External collaborations significantly boosted donor numbers but donation rates lag behind internal sources.
• Addressing logistical challenges in external networks is crucial.
• Improving external procurement can strengthen local tissue supply and reduce reliance on imported corneas.