Association of Federal Regulations in the United States and Canada With Potential Corneal Donation by Men Who Have Sex With Men

Michael A Puente,Helio V Neves Da Silva,Alan G Palestine,Conan Chen,Michael J Taravella,Binhan Pham,Jennifer L Patnaik,Chad M Caplan,Blake M Snyder,Anne M Lynch

doi:10.1001/jamaophthalmol.2020.3630

Michael A Puente, Helio V Neves Da Silva + Show 8 more

Open Access

https://doi.org/10.1001/jamaophthalmol.2020.3630

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Abstract

Federal policy in the United States prohibits corneal donation by men who have had sex with another man (MSM) in the preceding 5 years, whereas Canada enforces a 12-month ban. The potential consequences of these policies on corneal donations should be evaluated. To estimate the number of potential corneal donations associated with MSM deferral policies in the United States and Canada. A nonvalidated telephone survey study was conducted of all 65 eye banks in the United States and Canada to investigate how many potential corneal donors were disqualified in 2018 because of federal MSM restrictions. Published demographic data were also used to arrive at a separate estimate. Survey data were gathered from May 2019 to February 2020. Eye banks were asked if they keep records of referrals disqualified specifically because of the federal MSM restrictions and, if so, how many referrals they disqualified in 2018 owing to MSM status. Fifty-four of 65 eye banks (83%) responded to the survey, with 30 eye banks reporting they do not keep specific records of MSM deferrals. The remaining 24 eye banks reported disqualifying 360 referrals in 2018 because of MSM status, equating to 720 corneas. The 24 eye banks accounted for 46.2% of corneal donations in the United States and Canada in 2018, yielding an estimate of approximately 1558 corneas rejected that year because of MSM status. A separate estimate using published MSM demographic data indicates that up to 3217 potential corneal donations may have been disqualified in 2018 because of these federal policies. Findings suggest that between 1558 and 3217 corneal donations were disqualified in 2018 because of federal regulations prohibiting corneal donation by men who have had sex with another man in the preceding 5 years in the United States or 1 year in Canada. With modern virologic testing that is reliable within days of HIV exposure and given the global shortage of corneal tissue, these policies should be reevaluated using current scientific evidence to increase the availability of vision-restoring surgery worldwide.

Highlights

MethodsStudy Design For this survey study, a list was obtained of all eye banks in the United States from a database published on the Eye Bank Association of America (EBAA) website.[12]
DESIGN, SETTING, AND PARTICIPANTS A nonvalidated telephone survey study was conducted of all 65 eye banks in the United States and Canada to investigate how many potential corneal donors were disqualified in 2018 because of federal MSM restrictions
Corneal donation involves a rigorous screening process designed to reduce the risk of infectious disease transmission via corneal transplant.[1]

Summary

Methods

Study Design For this survey study, a list was obtained of all eye banks in the United States from a database published on the EBAA website.[12]. We contacted all 65 of these eye banks (57 in the United States and 8 in Canada, including the eye bank of Quebec) and conducted a nonvalidated retrospective telephone survey asking the following questions: (1) if they document when a referral is disqualified for corneal donation because of MSM contact, (2) how many referrals they rejected in the 2018 calendar year owing to MSM status, and

Results

Discussion

Conclusion