Abstract
Corneal transplantation is a safe, reliable method of restoring visual acuity in patients with corneal disorders. Although it has a very high success rate, rejection can still occur, especially if the site is infected. Therefore, seeking to find better ways to manage infection risk, this study investigated a new technique, based on multiplex polymerase chain reaction (mPCR), to identify pathogens, including viruses, bacteria, and fungi, in corneal transplantation recipient sites, donor corneas and the donor cornea storage solution. The subjects comprised 50 patients who underwent corneal transplantation at Tohoku University Hospital between July 2014 and April 2015. We obtained extracted (recipient) cornea samples in 37 cases, donor cornea samples in 50 cases, and corneal storage solution samples in 50 cases (18 of these 50 samples contained DNA). Herpes simplex virus type 1 DNA was detected in four recipient corneas, Parvovirus B19 DNA was detected in two recipient corneas, Human herpes virus type 6 was detected in two donor corneas, and Aspergillus DNA was detected in one corneal storage solution sample. Thus, mPCR successfully identified pathogenic DNA in corneal tissues and storage solution, suggesting that evaluation with mPCR may improve the ability to predict the risk of infection after corneal transplantation.
Highlights
Corneal opacity is a common cause of blindness with many causes
Important advantage of polymerase chain reaction (PCR) is that it allows the use of multiplex techniques that can simultaneously test for multiple types of pathogen, including viruses, bacteria, and fungi, in a single sample
This study showed that multiplex polymerase chain reaction (mPCR) analysis can reveal the presence and type of pathogen DNA in three vectors of infection after corneal transplantation: the recipient, the donor cornea, and the donor cornea storage solution
Summary
Corneal opacity can occur as a complication of corneal transplantation when the transplant site becomes infected. Recovery from such infection is extremely slow due to the low number of corneal blood vessels and corneal immune privilege[1]. The cornea is an immune privileged site, immunosuppressive drugs are often used to ensure that transplant rejection does not occur after corneal transplantation. Fungal infection in the donor storage solution has been reported to affect graft survival after transplantation[7]. These risks make it essential to be aware of infectious symptoms in the perioperative period. Important advantage of PCR is that it allows the use of multiplex techniques (mPCR) that can simultaneously test for multiple types of pathogen, including viruses, bacteria, and fungi, in a single sample
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