The potential for eye donation from hospice and palliative care clinical settings in England: a retrospective case note review of deceased patients' records

Abstract

There is a need to identify additional routes of supply for ophthalmic tissue in the UK. This paper reports the findings from a national study exploring the potential for eye donation (ED) from three Hospice Care (HC) and three Hospital Palliative Care Services (HPC) in England. The objectives addressed in this paper are i.) to establish the size and describe the clinical characteristics of the potential eye donor population across six clinical sites; ii.) to identify challenges for clinicians in applying the standard ED criteria for assessing patient eligibility. Retrospective assessment of 1199 deceased patient case notes, 601 Hospice Care and 598 Hospital Palliative Care services, against current eye donation criteria. Clinicians’ assessments were then evaluated against the same criteria. by specialists based at the National Health Service Blood and Transplant Tissue Services division (NHSBT-TS). Results of the assessment and evaluation are reported as descriptive statistics (numerical data). Free-text comment boxes facilitated clarification and/or justification of review and evaluation decisions. 46% (n = 553) of 1199 deceased patients’ notes were agreed as eligible for eye donation (Hospice care settings = 56% (n = 337); Palliative care settings = 36% (n = 216). For all eligible cases (n = 553) the option of ED was recorded as being raised with family members in only 14 cases (3%). Significant potential exists for eye donation from the clinical sites in this study. This potential is not currently being realised.

Views of admitted palliative care patients and their clinicians on corneal donation discussions differ: A qualitative content analysis of semi-structured interviews

“…There is a severe worldwide shortage of donated corneas for transplantation and research purposes. [1][2][3] Although malignancy of solid organs is a contraindication for most organ donations, corneas are one of the few tissues that patients with cancer can donate. [4] Studies show that while intensive care patients have a high uptake of corneal donations, other patient groups show limited uptake.…”