The New Zealand National Eye Bank study 1991-2003: a review of the source and management of corneal tissue.
OBJECTIVE
To evaluate donor demographics and source, donor tissue processing and storage, biologic contamination, and the utilization and distribution of corneal tissue procured by the New Zealand National Eye Bank.


METHODS
As part of a prospective longitudinal study, the electronic records of the NZNEB for the 13-year period 1991-2003 were analyzed for each year with respect to donor demographics, donor source and cause of death, death-to-preservation interval, storage methods, endothelial assessment, biologic contamination, corneal tissue utilization, and distribution.


RESULTS
During the study period, 3221 corneas were retrieved from 1628 donors (69.8% male, 30.2% female), with the mean age of donors 59.4 years (SD 18.3 years) and range 4 to 95 years. No significant correlation was identified between donor age group (using 10-year intervals) and the proportion of corneas suitable for transplantation. Donors were procured from the Coroner's service (67.6%), public hospitals, (23.5%) and multiorgan donors (7.1%). The most common causes of donor death were cardiovascular disease, trauma, and cerebrovascular disease. Average storage duration increased from 3.5 to 11.8 days when organ culture replaced hypothermic storage in 1992. Biologic contamination occurred in 5% of all donor corneas. The most common bacterial and fungal isolates were coagulase-negative staphylococci and Candida spp, respectively. A significant decrease in contamination rate over the years of the study was identified. Overall, 79.4% of corneal tissue procured was used for corneal transplantation (75.8% for penetrating keratoplasty, 2.1% for lamellar keratoplasty, and 1.5% for unspecified transplants), and 21.6% was discarded. Most common reasons for discarding tissue were biologic contamination, abnormal serology, and failed endothelial assessment.


CONCLUSIONS
Analysis of the NZNEB database provides valuable information in relation to eye banking and corneal transplantation in New Zealand. Significant trends were identified in donor demographics, donor procurement source, improved donor tissue processing and storage, decreased biologic contamination, and increased utilization of corneal tissue.
Patel
Hussain Y
HY
Department of Ophthalmology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Brookes
Nigel H
NH
Moffatt
Louise
L
Sherwin
Trevor
T
Ormonde
Sue
S
Clover
Gillian M
GM
McGhee
Charles N J
CN
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D003315:Cornea; D016039:Corneal Transplantation; D016208:Databases, Factual; D004728:Endothelium, Corneal / Q000166:cytology; D005125:Eye Banks / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D009926:Organ Preservation / Q000379:methods / Q000706:statistics & numerical data; D011446:Prospective Studies; D017678:Sex Distribution; D013997:Time Factors; D014019:Tissue Donors / Q000706:statistics & numerical data*; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*