title: Reducing contamination when removing and storing corneas: a multidisciplinary, transversal, and environmental approach.
abstract: OBJECTIVE
  The combination of a shortage of cornea grafts in France and a national average contamination rate of 9% to 10%, has led us to search for the origins of this contamination. The objective of our study was to reduce the number of unusable grafts resulting from contamination of corneas in organ culture.
  
  
  METHODS
  An external audit was carried out by an independent pharmacist on the removal conditions and treatment procedures for corneas. An environmental study was carried out, consisting of microbiological sampling of the corneas of donors who just died (<24 hours) as well as water and air samples in the premises used for removal. The Cornea Bank's procedures were submitted to a microbiological risk analysis using the "failure mode effects and criticity analysis" (FMECA) method.
  
  
  RESULTS
  The critical contamination periods were found to be before removal, during mortuary washing and during decontamination of the conjunctival cul-de-sac at the removal stage. The corrective measures taken have reduced contamination rates by half in 1 year.
  
  
  CONCLUSIONS
  Highlighting the sources of contamination has led to the implementation of effective targeted and low-cost measures that have allowed us to reduce significantly the number of cornea graft losses as a result of bacterial and fungal contamination.
authors.affiliation: Banque de Cornées des Hospices Civils de Lyon, Lyon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Builles
authors.forename: Michel
authors.initials: M
authors.lastname: Perraud
authors.forename: Marie-Elisabeth
authors.initials: ME
authors.lastname: Reverdy
authors.forename: Carole
authors.initials: C
authors.lastname: Burillon
authors.forename: Philippe
authors.initials: P
authors.lastname: Crova
authors.forename: Frédéric
authors.initials: F
authors.lastname: Brun
authors.forename: François
authors.initials: F
authors.lastname: Chapuis
authors.forename: Odile
authors.initials: O
authors.lastname: Damour
mesh_terms: D003315:Cornea; D016039:Corneal Transplantation; D004340:Drug Contamination / Q000517:prevention & control*; D004781:Environmental Exposure / Q000009:adverse effects*; D006801:Humans; D009924:Organ Culture Techniques; D019188:Organ Preservation Solutions / Q000592:standards*; D012307:Risk Factors; D014019:Tissue Donors; D014021:Tissue Preservation / Q000379:methods*
chemical_list: D019188:Organ Preservation Solutions