Shortage in the face of plenty: improving the allocation of corneas for transplantation.
BACKGROUND
As there are plenty of potential corneal donors, theoretically there should be no shortage of corneal grafts. Practically, however, shortages have been a problem, especially with HLA-matched corneas, which are increasingly requested. This increase requires evaluation and proper adaptation to meet all requests in the future.


METHODS
BIS' allocation data for corneal transplants were analyzed for the years 1998 through 2001.


RESULTS
Allocation of matched corneas almost doubled in 2000. The waiting list for matched grafts could be reduced by one third.


CONCLUSIONS
A steep increase in demand for matched grafts could be noted by the year 2000. This signifies that the results of positive matching studies have ultimately been taken notice of by the ophthalmic surgeons with consequent adaptation of their graft orders. BIS has mostly been able to cope with these rapidly changing and increasing demands, but more efforts are continuously needed to supply those typed and matched corneas within short time. Our next step will be to offer HLA-DR matching routinely in addition to the current HLA-A/-B matching. We are looking forward with great interest to the introduction of even more specified matching algorithms in the not too far distant future, and are prepared to meet all the requirements which might be associated with such challenges.
de By
T M M H
TM
BIS Foundation, Leiden, The Netherlands. theodeby@bisfoundation.nl
D003315:Cornea; D016039:Corneal Transplantation / Q000639:trends*; D006650:Histocompatibility Testing / Q000706:statistics & numerical data; D006801:Humans; D040841:Resource Allocation / Q000706:statistics & numerical data / Q000639:trends*; D014019:Tissue Donors; D014184:Transplantation, Homologous; D014850:Waiting Lists