Limitierte Verfügbarkeit von potenziellen Hornhaut-Spendern: Gründe und Verbesserungsvorschläge

Rosenbaum, Katja; Rottler, Jessica; Steinbach, R.; Huber, K. K.

doi:10.1055/s-0028-1109889

Cited by 6 publications

(4 citation statements)

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“…But in practice relatives didn't ask the coordinators for so much details about research aims. Our high acceptance rate for transplantation was significantly higher than those reported for transplantation in literature [18,21,23] where rates exceeding two-thirds acceptance are exceptional [16,24,25]. Comparison between the teams is highly complex because it questions donation regulation, overall organization of the teams, donors screening and experience of the coordinators evolving over time.…”

Section: Plos Onementioning

confidence: 65%

“…patients; 3/ older age (10 years) in the research group can make higher consent rate [20]; 4/ great experience of the coordinators in presenting legislation and research issues with empathy plays a key role [3,21,22]; 5/ longstanding [16] involvement of the coordinators in research projects, directly related here to improve corneal grafts storage keeps motivation over time; 6/ general public's knowledge of our health region and team's research works (dedicated mainly but not only to corneal eyebanking and transplantation) through regular follow-up support for the relatives may help to make meaning of donation. But in practice relatives didn't ask the coordinators for so much details about research aims.…”

Section: Plos Onementioning

confidence: 99%

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Corneal donation for research versus for transplantation: A-year prospective study of acceptance rates in a French University Hospital

et al. 2020

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Fresh corneal donation is essential for basic and preclinical research, but more unknown to public and the medical teams than donation for transplantation: it may raise concerns. We prospectively compared the acceptance rates and the characteristics of targeted corneal donation for research versus donation for transplantation during one year. The Agence de la Biomé decine authorized us to procure fresh corneas targeted for research, only from the donors with medical contraindications for transplantation, in order not to increase grafts shortage. Three nurses from the hospital coordination team of Saint-Etienne University Hospital, obtained consent for research and transplantation in parallel, screening all intra-hospital deaths cases, following standard protocol to check no refusal from families, despite the French opt-out system. They contacted 127 families for research and 244 for transplantation, in 71% of cases by telephone. Consent was obtained in 62% of cases for research and 54% for transplantation (P = 0.135). The main contraindication for transplantation was the cognitive disorders (66%) followed by the blood cancers (8%). This new specific activity, providing new source of fresh corneas for research immediately usable without any eyebank storage steps, didn't reduce the number of corneas procured for transplantation versus previous years (P = 0.998). Donors in the research group were 10 years older (P<0.001) without difference regarding endothelial cell quality (P = 0.071), allowing maximal clinical relevance for protocols using these fresh human scientific corneas provided by targeted donation.

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Section: Plos Onementioning

confidence: 65%

Section: Plos Onementioning

confidence: 99%

Corneal donation for research versus for transplantation: A-year prospective study of acceptance rates in a French University Hospital

et al. 2020

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“…Auf dem dritten Platz folgten gleichauf die folgenden 4 Arbeiten. Die Studie mit dem Titel "Limitierte Verfügbarkeit von potenziellen Hornhautspendern: Gründe und Verbesserungsvorschläge" [4] von K. Rosenbaum, J. Rottler, R. Steinbach und K.-K. Huber hat zum Ergebnis, dass trotz großen personellen und zeitlichen Aufwands nur 6% aller potenziellen Spender die Hornhäute entnommen werden. Die Autoren empfehlen, Ärzte, Pfleger und Schwestern, aber auch die Bevölkerung durch vermehrte Schulung und Öffentlichkeitsarbeit von der Wichtigkeit der Hornhautspende zu überzeugen.…”

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Die Klinischen Monatsblätter, der Theodor-Axenfeld-Preis und ein Blick in die Zukunft!

Lang¹

2011

Klin Monatsbl Augenheilkd

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Optical coherence tomography provides high-resolution images of the anterior segment (AS-OCT). When used as a measuring tool, corneal thickness, anterior and posterior chamber depths, anterior chamber diameter and chamber angle configuration are defined reproducibly. In terms of an optical biopsy by cellular imaging, tissue infiltration, deformation and deposits can be analysed microstructurally. A comparison of pre- and post-operative, as well as long-term follow-up of pathological findings are possible. Examination with AS-OCT is a no-contact procedure, and is well tolerated by the patient. The following instruments were used: Visante-OCT and Cirrus HD-OCT (Carl Zeiss Meditec GmbH, Germany) and SS100 CASIA (Tomey Europe, Erlangen).

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“…All methods still require a donor cornea, and the worldwide shortage of transplantable donor corneas, ongoing cell damage after transplantation, and primary graft failure are issues that remain to be resolved. 5,6 However, from a technical point of view, corneal surgeons are now ready to replace the diseased corneal endothelium with a thin lamellar posterior donor consisting of a tissue-engineered endothelium reconstructed on a thin carrier. 7 Tissue engineered corneal endothelium may overcome the shortage.…”

mentioning

confidence: 99%

Electrospun nanofibrous SF/P(LLA-CL) membrane: a potential substratum for endothelial keratoplasty

Chen¹,

Yan²,

Zhu³

et al. 2015

IJN

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Background Cornea transplant technology has progressed markedly in recent decades, allowing surgeons to replace diseased corneal endothelium by a thin lamellar structure. A thin, transparent, biocompatible, tissue-engineered substratum with corneal endothelial cells for endothelial keratoplasty is currently of interest. Electrospinning a nanofibrous structure can simulate the extracellular matrix and have beneficial effects for cell culture. Silk fibroin (SF) has good biocompatibility but poor mechanical properties, while poly( l -lactic acid-co-ε-caprolactone) (P(LLA-CL)) has good mechanical properties but poor biocompatibility. Blending SF with P(LLA-CL) can maintain the advantages of both these materials and overcome their disadvantages. Blended electrospun nanofibrous membranes may be suitable for regeneration of the corneal endothelium. The aim of this study was to produce a tissue-engineered construct suitable for endothelial keratoplasty. Methods Five scaffolds containing different SF:P(LLA-CL) blended ratios (100:0, 75:25, 50:50, 25:75, 0:100) were manufactured. A human corneal endothelial (B4G12) cell line was cultured on the membranes. Light transmission, speed of cell adherence, cell viability (live-dead test), cell proliferation (Ki-67, BrdU staining), and cell monolayer formation were detected on membranes with the different blended ratios, and expression of some functional genes was also detected by real-time polymerase chain reaction. Results Different blended ratios of scaffolds had different light transmittance properties. The 25:75 blended ratio membrane had the best transmittance among these scaffolds. All electrospun nanofibrous membranes showed improved speed of cell adherence when compared with the control group, especially when the P(LLA-CL) ratio increased. The 25:75 blended ratio membranes also had the highest cell proliferation. B4G12 cells could form a monolayer on all scaffolds, and most functional genes were also stably expressed on all scaffolds. Only two genes showed changes in expression. Conclusion All blended ratios of SF:P(LLA-CL) scaffolds were evaluated and showed good biocompatibility for cell adherence and monolayer formation. Among them, the 25:75 blended ratio SF:P(LLA-CL) scaffold had the best transmittance and the highest cell proliferation. These attributes further the potential application of the SF:P(LLA-CL) scaffold for corneal endothelial transplantation.

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Limitierte Verfügbarkeit von potenziellen Hornhaut-Spendern: Gründe und Verbesserungsvorschläge

Abstract: The final consent rate was only 6 % out of all potential donors. Organisational failure was only 16 % in contrast to 60 % refusal due to causes relating to medical staff and relatives. Therefore, further education of physicians and the public is needed.

Cited by 6 publications

References 4 publications

Corneal donation for research versus for transplantation: A-year prospective study of acceptance rates in a French University Hospital

Corneal donation for research versus for transplantation: A-year prospective study of acceptance rates in a French University Hospital

Die Klinischen Monatsblätter, der Theodor-Axenfeld-Preis und ein Blick in die Zukunft!

Electrospun nanofibrous SF/P(LLA-CL) membrane: a potential substratum for endothelial keratoplasty

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