Factors influencing endothelial cell density of corneas for transplantation

Sampaio, Thatiane Lima; Rodrigues, Isabela Pereira; Cresta, Micheline Borges Lucas; Queiroz, Anna Cláudia de Oliveira; Victer, Thayssa Neiva da Fonseca; Pontes, Daniela Ferreira Salomão; Araújo, Wildo Navegantes de; Báo, Sônia Nair; Chalita, Maria Regina

doi:10.1007/s10561-020-09875-8

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…One study suggests a maximum death-to-enucleation of 24 hours only in circumstances where the donor body has been refrigerated at 2–8°C within 6 hours of death, highlighting the importance of rapid cooling. 20 In contrast, European studies which utilize organ culture have demonstrated that DTP times of up to 72 hours have no influence on the quality of transplanted corneas or transplantation outcomes, irrespective of DTC. 21 The influence of DTC times may be impacted by the local climate and environmental factors and could therefore vary by region.…”

Section: Discussionmentioning

confidence: 99%

Impact of Donor, Recipient, and Graft Characteristics on Corneal Transplantation Outcomes

Shah¹,

Hasan²,

Winokur³

et al. 2023

OPTH

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Purpose Although several donor, recipient, and graft characteristics have been studied in relation to corneal transplantation outcomes, no study to our knowledge has assessed the impact of donor cooling times on postoperative outcomes longitudinally. With only one corneal graft available for every 70 needed worldwide, this study seeks to identify any factors that could alleviate this shortage. Methods Patients undergoing corneal transplantation at the Manhattan Eye, Ear & Throat Hospital over a 2-year period were retrospectively studied. Study metrics included age, diabetic history, hypertensive history, endothelial cell density, death-to-preservation time (DTP), death-to-cooling time (DTC), and time-in-preservation (TIP). Postoperative transplantation outcomes, including best corrected visual acuity (BCVA) at 6- and 12-month follow-up visits, need for re-bubbling, and need for re-grafting, were assessed. Unadjusted univariate and adjusted multivariate binary logistic regressions were performed to determine the association of cooling and preservation parameters with corneal transplantation outcomes. Results Among 111 transplants, our adjusted model found that DTC ≥4 hours was associated with significantly worse BCVA, but only at 6-month postoperative follow-up (odds ratio [OR]: 0.234; 95% confidence interval [CI]: 0.073–0.747; p = 0.014). By 12-month follow-up, DTC > 4 hours was no longer associated with BCVA in a statistically significant manner (OR: 0.472; 95% CI: 0.135–1.653; p = 0.240). A similar trend was found at a DTC cutoff of ≥3 hours. None of the other studied parameters, including DTP, TIP, donor age, or medical history were significantly correlated with transplantation outcomes. Conclusion Longer DTC or DTP did not have a statistically significant effect on corneal graft outcomes after one year, though short-term outcomes were improved in donor tissues with DTC below four hours. None of the other studied variables correlated with transplantation outcomes. Given the global shortage of corneal tissue, these findings should be considered when determining suitability for transplantation.

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Section: Discussionmentioning

confidence: 99%

Impact of Donor, Recipient, and Graft Characteristics on Corneal Transplantation Outcomes

Shah¹,

Hasan²,

Winokur³

et al. 2023

OPTH

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“…Various studies have evaluated factors affecting the endothelial cell density,[ 5 6 ] and fewer so have evaluated the factors affecting donor epithelium integrity. Some studies have performed comparisons among two or more tissue storage media in maintaining the health of the epithelium.…”

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confidence: 99%

Factors affecting the epithelial integrity of human donor corneas

Kaur

Mohamed

Priyadarshini

et al. 2023

Indian J Ophthalmol

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Purpose: To evaluate various factors affecting the integrity of human donor corneal epithelium. Methods: Donor corneal buttons were evaluated for epithelial defect (ED) and exposure. The slit-lamp photographs were taken on day 01, and the data such as age and gender of the donor, cause of death, refrigeration of cadavers, death-to-preservation time (DPT), experience of technician, and distance from site of collection to eye bank were collected. Results: A total of 100 consecutive corneal buttons belonging to 56 donors were evaluated. The median age of donors was 50 years. Males constituted 45 (80.4%). The mean DPT was 9.7 ± 5.3 hours. After death, 34 donors (60.7%) were refrigerated before the collection/retrieval. Most of the corneas (80%) were recovered by technicians having an experience of 0–5 years. Thirty-one donors (55.3%) were located at 1–50 km from the eye bank. The mean area of exposure was 15 ± 4.3 mm 2 . The mean area of ED was 28.7 ± 5.9 mm 2 . ED was significantly associated with refrigeration of cadavers and longer DPT. On multivariate analysis, only DPT was found to be significantly associated ( P = 0.006; odds ratio [OR] = 1.54 ± 0.24) with the presence of ED. After transplantation, only two corneas had persistent epithelial defects and were treated successfully using various interventions. Conclusion: Integrity of donor corneal epithelium is mainly influenced by the refrigeration of cadavers and DPT.

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“…5–8 Cause of death, chronic disease of donor, death-to enucleation time, and enucleation-to-preservation time are other factors that have been reported to influence ECD. 9–11…”

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confidence: 99%

“…[5][6][7][8] Cause of death, chronic disease of donor, death-to enucleation time, and enucleation-to-preservation time are other factors that have been reported to influence ECD. [9][10][11] Some studies have shown a correlation between cause of death and ECD. Grafts from donors who died from chronic diseases (eg, cancer, sepsis) have lower ECD compared with donors who died from more acute causes (eg, myocardial infarction, pulmonary embolism, or intracerebral hemorrhage).…”

mentioning

confidence: 99%

Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

Oseni

Rand

Moon

et al. 2022

Cornea

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The purpose of this study was to examine the effect of head trauma-related deaths on corneal endothelial cell density (ECD) in eye bank donors.Methods: This is a retrospective study of 287 corneas from donors with causes of death secondary to motor vehicle accident with sustained head trauma (n = 50), gunshot wound to the head (n = 138), fall with sustained head trauma (n = 2), and nonhead-related traumatic causes of death (n = 97). Donors older than age 50 years were excluded due to concern for undiagnosed Fuchs endothelial dystrophy as a potential confounder for the cause of endothelial cell loss. Donor characteristics, ECD, and focal endothelial cell loss on specular microscopy were compared between the groups. Donors in the head trauma and nonhead trauma groups were matched by age; there were 42 age-matched donors in both groups.Results: Age and ECD were negatively correlated (Pearson correlation coefficient = 20.57). Death-to-preservation time was not significantly different between the 2 groups (P value = 0.59). The mean ECD in the head trauma group was 2859 6 370 cells/mm 2 and 3041 6 464 cells/mm 2 in the nonhead trauma group. The head trauma group had a lower ECD (178 6 70 cells/mm 2 , P value = 0.013). After matching for age, the difference in ECD between the 2 groups was 294 6 82 cells/mm 2 (P value = 0.26). The adjusted odds of having focal endothelial cell loss was not statistically significant (P value = 0.50) between the groups.Conclusions: After statistical adjustments, there were no differences between the head trauma and nonhead trauma groups.

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Factors influencing endothelial cell density of corneas for transplantation

Cited by 5 publications

References 24 publications

Impact of Donor, Recipient, and Graft Characteristics on Corneal Transplantation Outcomes

Impact of Donor, Recipient, and Graft Characteristics on Corneal Transplantation Outcomes

Factors affecting the epithelial integrity of human donor corneas

Effect of Head Trauma–Related Deaths on Corneal Endothelial Cell Loss in Eye Bank Donors

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