Factors involved in the occurrence of bleeding complications after enucleation for cornea donation.
OBJECTIVE
To identify risk factors for the occurrence of bleeding complications after enucleation for cornea donation, in order to develop preventive activities to reduce the occurrence of bleeding complications and especially the development of ocular hematomas.


METHODS
From all Dutch cornea donors deceased in the year 2006, donor characteristics, retrieval characteristics, and bleeding complication data were collected. First, univariate relations between donor and retrieval factors and bleeding complications were determined. Then, multivariate logistic regression analysis was used to identify factors significantly associated with bleeding complications.


RESULTS
In 114 of the 1173 cornea donors (9.7%), bleeding complications occurred, with ocular hematomas developing in 39 (3.3% of all cornea donors). Donor factors significantly associated with bleeding complications were age [odds ratio (OR) 0.96 (95% CI 0.94-0.97)], weight [OR 1.03 (1.02-1.04)], heart failure [OR 2.10 (1.12-3.94)], thrombocyte aggregation inhibitor use [OR 1.64 (1.02-2.64)], and chronic alcoholic liver disease [OR 2.85 (1.11-7.31)]. The most significant factor associated with bleeding complications was the retrieval sequence. If cornea donation was followed by any other tissue retrieval, the risk of bleeding complications was strongly increased.


CONCLUSIONS
: This study shows that the tissue retrieval sequence in multitissue donors is the most important factor associated with the occurrence of bleeding complications. The risk of bleeding and ocular hematoma is lower if cornea donation is performed after all other retrievals. However, if the tissue retrieval sequence is altered, the effect of prolonged postmortem time on corneal quality must be taken into account.
van Wijk
Marja J
MJ
Foundation, 2301 CH Leiden, The Netherlands. m.vanwijk@bisfoundation.nl
Nijenhuis
Matthijs V
MV
Dorrepaal
Caroline A
CA
Bokhorst
Arlinke G
AG
D001824:Body Constitution; D003315:Cornea; D015353:Eye Enucleation / Q000009:adverse effects*; D005130:Eye Hemorrhage / Q000209:etiology*; D005260:Female; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014019:Tissue Donors; D009927:Tissue and Organ Procurement