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. 2021 Feb;48(1):3-11.
doi: 10.1159/000510588. Epub 2020 Oct 8.

Cornea Procurement and Processing up to 72 Hours: No Risk for Cornea Transplant Quality

Nicola Hofmann  1 , Ilka Wittmershaus  1 , Anna-Katharina Salz  1 , Martin Börgel  1
Affiliations

Cornea Procurement and Processing up to 72 Hours: No Risk for Cornea Transplant Quality

Nicola Hofmann et al. Transfus Med Hemother. 2021 Feb.

Abstract

Background: The realization of tissue donations is bound to a tight timeframe. Depending on the type of tissue, time limits are specified within which the donation must be procured and processed. Otherwise, there is a risk of tissue quality loss with increasing time intervals from cardiovascular arrest. According to the European Directorate for the Quality of Medicines and HealthCare (EDQM) guide, cornea must be procured and processed within 72 h after death. The question arises whether this time interval has an influence on the quality of transplanted tissues and how it affects the accomplishment of tissue donations.

Methods: In order to obtain information on this, the numbers of tissue donations in the network of the German Society for Tissue Transplantation (DGFG) were evaluated as a function of the death to retrieval time (DRT) as well as the death to preservation time (DPT). For this purpose, 21,454 database entries of cornea donations made in the period from 2014 to 2018 were included.

Results: The results show that nearly 50% of donations realized in the DGFG network could be processed only 48 h or later after cardiovascular death due to the opt-in regulation in Germany. For these donations, there seems to be a higher discard rate compared to donations taken earlier. Nevertheless, there is a transplantation rate for these grafts of more than 65%, which is comparable to average transplantation rates stated in the literature.

Conclusion: All corneas finally selected for transplantation must meet the specified quality parameters. Since this naturally also applies to transplants that could only be procured at later time points, it can be concluded that DPT up to 72 h for corneal tissue is adequate and has no influence on the quality of corneas that are ultimately transplanted.

Keywords: Cornea safety and quality; Death to preservation time; Tissue donation.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
a Total donations and donor age related to DRT (DGFG, 2014–2018, n = 21,454 corneas). b Total donations and donor age related to DPT (DGFG, 2014–2018, n = 21,454 corneas).
Fig. 2
Fig. 2
a Tx rate and discard rate related to DRT (DGFG, 2014–2018, n = 21,454 corneas) (∑ Tx rate: DRT ≤24 h: 73.02%; DRT >24 and ≤48 h: 66.39%; DRT >48 and ≤72 h: 61.10%; total: 68.16%). b Tx rate and discard rate related to DPT (DGFG, 2014–2018, n = 21,454 corneas) (∑ Tx rate: DPT ≤24 h: 75.72%; DPT >24 and ≤48 h: 70.77%; DRT >48 and ≤72 h: 64.52%; total: 68.16%). Tx, transplantation.
Fig. 3
Fig. 3
a Endothelial cell density (cells/mm2) related to donor age (DGFG, 2014–2018, n = 14,564) (grey dots; F[1.14562] = 869.1, p < 2.2e-16). b Endothelial cell density (cells/mm2) related to DRT (DGFG, 2014–2018, n = 14,564) (grey dots; F[1.14562] = 234.5, p < 2.2e-16). c Endothelial cell density (cells/mm2) related to DPT (DGFG, 2014–2018, n = 14,564) (grey dots; F[1.14562] = 124.9, p < 2.2e-16).
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