Allocation of corneas in europe

Abstract

Background: To safeguard a fair distribution of available corneas, (inter)national and regional allocation principles have to be developed and implemented.

Methods: To obtain information about allocation principles over the world, a literature search was done. Allocation in Europe was investigated by international data of Bio Implant Services Foundation (BIS) over the period 2002-2007.

Results: For 4 different types of corneal grafts, e.g. random, HLA-typed, lamellar and emergency corneas, different allocation principles are described. Applying allocation criteria leads to dynamics in the donor and patient pool, which could be monitored by establishing the mean waiting time for each kind of corneal graft. Specific attention should be given to the division of corneas over the pools of different graft types, to ensure equal access to a transplant for all cornea patients.

Conclusions: Due to new surgical techniques and seasonal changes in the supply of corneal grafts, allocation is a dynamic process, which has to be closely monitored.