gms | German Medical Science

Purpose: 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 for discarding corneas were medical contraindication and poor endothelial quality. Donor age had the strongest influence on suitability for transplantation. Corneas from donors aged 80 years and older were more likely to be discarded because of endothelial insufficiency (P < 0.0001). Cause of donor death including infection and multiple organ dsyfunction syndrom (MODS) increased the risk of bacterial or fungal contamination during organ culture (P = 0.0069 and P = 0.0140, respectively). Increased time between death and enucleation was associated with increased risk of unsuitability for transplantation (P < 0.0001). Increased time between death and corneoscleral disc excision and increased storage time had influence on suitability for transplantation (P = 0.0007 and P < 0.0001, respectively).

Conclusion: Donor age, cause of death, storage time, death to enucleation and death to disc excision times influenced the suitability of corneas for transplantation. 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 advocate setting a donor age limit.