title: Infectious disease risk factors of corneal graft donors.
abstract: OBJECTIVE
  To determine how donor health status affects the risk of infection after corneal transplant.
  
  
  METHODS
  An adverse reaction surveillance registry was used to conduct a matched case-control study among transplanted donor corneas from January 1, 1994, to December 31, 2003. Cases comprised 162 reports of endophthalmitis after penetrating keratoplasty including 121 with microbial recovery, of which 59 had concordant donor and recipient microbial isolates. Two controls were matched to each case by surgery date. Conditional logistic regression estimated adjusted odds ratios with 95% confidence intervals according to the premortem status of decedent donors.
  
  
  RESULTS
  Postkeratoplasty endophthalmitis was associated with recent hospitalization (odds ratio, 2.84; 95% confidence interval, 1.61-4.98) and fatal cancer (odds ratio, 2.46; 95% confidence interval, 1.53-3.97) among donors. Endophthalmitis appeared more likely with tissues transplanted longer than 5 days after donation (odds ratio, 1.55; 95% confidence interval, 1.02-2.35). The prevalence of concordant microbial isolates from donors and recipients was greater among fungal endophthalmitis than among bacterial endophthalmitis (P < .001).
  
  
  CONCLUSIONS
  Corneal grafts with eye tissue obtained from donors dying in the hospital or with cancer may have an increased risk of postsurgical endophthalmitis, possibly due to donor-to-host microbial transmission. Together with donor screening and processing, improvements in microbiological control may reduce infection associated with corneal transplant.
authors.affiliation: Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin St, NC-205, Houston, TX 77030, USA.
authors.forename: Sohela S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Kirk R
authors.initials: KR
authors.lastname: Wilhelmus
authors.forename: Patricia
authors.initials: P
authors.lastname: Dahl
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Davis
authors.forename: Russell T
authors.initials: RT
authors.lastname: Roberts
authors.forename: Kevin W
authors.initials: KW
authors.lastname: Ross
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Varnum
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D016001:Confidence Intervals; D003315:Cornea; D018562:Disease Transmission, Infectious; D009877:Endophthalmitis / Q000382:microbiology / Q000635:transmission*; D005125:Eye Banks / Q000706:statistics & numerical data; D015817:Eye Infections / Q000382:microbiology / Q000635:transmission*; D006304:Health Status; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000009:adverse effects*; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D011183:Postoperative Complications; D012042:Registries / Q000706:statistics & numerical data; D012307:Risk Factors; D014019:Tissue Donors; D014481:United States