Eye bank procedures: donor selection criteria

Abstract

Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

Principais motivos de descarte de córneas para transplante na Paraíba: por que o anti-HBc merece atenção?*

“…Os transplantes de órgãos sólidos não podem ser equiparados aos transplantes de córnea; a córnea é avascular, e a pessoa que a recebe geralmente não é imunossuprimida, situação que ocorre nos transplantes de órgãos sólidos. (22) Mais estudos devem ser realizados para analisar o risco de transmissão de doenças por meio de transplantes de córnea, assim como quais as medidas ou testes com maior sensibilidade e especificidade estão disponíveis para a triagem de potenciais doadores. Dessa forma, futuramente, será possível identificar, de uma forma mais segura, quais são aqueles tecidos para transplante que indicam real perigo de infecção ao receptor, aproveitando melhor a sua disponibilização e reduzindo, assim, os descartes.…”

Conjunctival melanoma following cornea transplant from a cancer donor: A case report

“… 5 The Current recommendations of the Eye Bank Associations of America and the European Eye Bank Association permit the use of corneas from donors dying of malignancy except for malignant tumors of the anterior ocular segment, retinoblastoma, active leukemia, and disseminated lymphomas. 30 …”

Characterization of cornea donors at a tissue center in the city of Medellin, Colombia

“…Eye banks must ensure the quality of corneal tissue by maintaining proper asepsis during tissue extraction, considering that any source of infection can lead to complications with a poor visual prognosis, such as graft infection and endophthalmitis (Singh et al 2019 ). Graft failure has been reported in up to 18.4%, with corneal infection being the most common cause (50%) (Sousa and Sousa 2018 ).…”