Donor Selection, Retrieval and Preparation of Donor Tissue

Abstract

Corneal transplantation safety is widely dependent on clinical donor selection. Donor-to-host transmission of rabies and Creutzfeldt-Jakob disease is well established, and it is lethal for the recipient. Taking into consideration this latter figure, contraindications to ocular tissue transplantation include not only rabies, contact with rabies virus, spongiform encephalitis, family history of spongiform encephalitis, recipients of human pituitary-derived hormones before 1987, surgery using dura mater and brain/spinal surgery before 1992, but also CNS diseases of unknown etiology or those with unknown risk of transmission. It has been established that hepatitis B virus and herpes simplex virus can be transmitted by corneal transplantation, and both diseases are contraindications to transplantation. HIV infection, syphilis, hepatitis C, hepatitis A, tuberculosis, HTLV-1 and -2 infection, active leprosy, active typhoid, smallpox and active malaria are also contraindications to ocular tissue transplantation even if no evidence of donor-to-recipient transmission has been demonstrated. A history of corneal refractive surgery in the donor eye, ocular inflammation, retinoblastoma, and malignant tumors of the anterior segment are contraindications to keratoplasty.

Validation of Spiked Postmortem Blood Samples from Cornea Donors on the Abbott ARCHITECT and m2000 Systems for Viral Infections

“…Over the last decade, various European and national directives and regulations have been passed to harmonize the process of donor acquisition, as well as the testing, preparation, storage, and distribution of corneal tissue [3-7]. In particular, screening of tissue donors for blood-derived viral infections such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) became mandatory in the context of the release of donor corneas for transplantation [8-11].…”

Influencing factors on the suitability of organ-cultured corneas

“…This led to rejection of corneas with poor endothelial cell density after preservation. [4][5][6][7] For more than 10 years, the number of corneas harvested has increased from 24 763 in 1996 to 39 051 in 2002 in Europe, 8 and from 3073 in 1995 to 6844 in 2002 in France. 9 In 2007, 32 080 donor corneas were processed by European eye banks.…”

Eye Banking and Corneal Transplantation Communicable Adverse Incidents

“…Although there is no evidence to date of disease transmission for HIV infection, syphilis, hepatitis C, hepatitis A, tuberculosis (TB), human T-cell lymphotropic virus (HTLV)-1 and HTLV-2 infection, active leprosy, active typhoid, smallpox, and active malaria, these entities remain contraindications for transplantation for all eye banks nationally and internationally. 22 The potential sources of contamination include infected donors, during the process of removing tissue from cadaveric donors, the processing environment, and contaminated supplies and reagents used during processing. Final sterility testing can be unreliable, especially when antibiotics remain on tissues or in the case of prion-transmitted diseases.…”