Abstract
With the discrepancy between availability and demand for corneal donors, the purpose of our study was to identify significant factors influencing the suitability and affecting the main reasons for discarding organ-cultured corneas. We thus aimed to minimise the percentage of unsuitable corneas in the long term. 4140 corneas of 2083 donors were analysed between 2006 and 2016. The factors included age, gender and medical history of the donors as well as storage factors such as post-mortem times. The data was recruited in a Microsoft Access database and evaluated with SPSS 20.0, using logistic regression analyses. In a multiple regression model, six factors influencing the suitability of the donor tissue were analysed. All corneas that did not meet the criteria for elective keratoplasty were considered unsuitable. A high donor age of > 80 years was found to be a significantly negative factor on the suitability of the cornea (p = 0.001) compared to the reference group of donors < 40years. Previous cataract surgery (p < 0.001) also significantly reduced suitability. Male corneas were significantly less suitable than female corneas (p = 0.028). Hypertension (p = 0.612), chemotherapy (p = 0.745) or diabetes mellitus (p = 0.321) did not significantly affect the suitability. Sepsis (p = 0.026) and multiorgan failure (p < 0.001) as cause of death resulted in significantly higher discarding rates due to contamination of the culture medium. Corneas in which the blood sample collection took more than 12 h from death of the donor had to be discarded significantly more frequently due to a positive donor serology. Factors such as a history of cataract surgery and high donor age reduced the suitability of corneal donor tissue in organ culture. Diabetes, arterial hypertension and chemotherapy in the donor history did not statistically significantly affect the suitability of donor tissue. Causes of death such as sepsis or multi-organ failure increased the contamination rate of the medium. Post-mortem blood collection after more than 12 h should be avoided due to increased positive serology results.
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