Factors that influence the suitability of human organ-cultured corneas.
OBJECTIVE
The purpose was to assess the influence of donor and storage factors on the suitability of organ-cultured corneas for transplantation.


METHODS
Data from 1340 donor corneas stored between 2009 and 2015 were analyzed retrospectively. Logistic regression analysis was used to assess the influence of different factors on the suitability of grafts for transplantation.


RESULTS
Forty-one percent (553/1340) of corneas were discarded. The leading causes were medical contraindication (20.2 %) and poor endothelial quality (19.3 %). Donor age influenced suitability for transplantation significantly. Corneas from donors aged 80 years and older were more likely to be discarded because of endothelial insufficiency (P < 0.0001). The cause of donor death including infection and multiple organ dsyfunction syndrom (MODS) increased the risk of bacterial or fungal contamination during organ culture (P = 0.007 and P = 0.014, respectively). Prolonged time between death and enucleation was associated with an increased risk of unsuitability for transplantation (P < 0.0001). The amount of time between death and corneoscleral disc excision and duration of storage influenced the suitability for transplantation (P = 0.0007 and P < 0.0001, respectively).


CONCLUSIONS
Donor age, cause of death, storage time, death to enucleation and death to disc excision times influenced transplantation suitability. The percentage of discarded corneas may be reduced by shortening storage time, death to enucleation, and death to corneoscleral disc excision times. Setting a maximum donor age could reduce the percentage of discarded corneas. However, as long as there is a lack of donor corneas, we do not recommend any donor age limit.
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany. tobias.roeck@med.uni-tuebingen.de.
T
T
Röck
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany.
J
J
Hofmann
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany.
S
S
Thaler
Department of General Medicine, Ruhr-University Bochum, Bochum, Germany.
M
M
Bramkamp
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany.
K U
KU
Bartz-Schmidt
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany.
E
E
Yoeruek
Centre for Ophthalmology, University of Tübingen, Schleichstr. 12, 72076, Tübingen, Germany.
D
D
Röck
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003315:Cornea; D016039:Corneal Transplantation; D005125:Eye Banks / Q000379:methods; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009924:Organ Culture Techniques; D009926:Organ Preservation; D012189:Retrospective Studies; D012307:Risk Factors; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting; D009927:Tissue and Organ Procurement
Corneal endothelial cells; Corneal organ culture; Corneal storage; Corneal suitability for transplantation