Screening Potential Cornea Donors for Signs of Sepsis

Abstract

Purpose: This study sought to expand upon previous works to explore correlations between cornea donor characteristics and incidence of sepsis/donor ineligibility. Methods: The medical records of 837 potential cornea donors with signs of possible sepsis from 2 Eye Bank Association of America–accredited eye banks between 2009 and 2022 were reviewed by an infectious disease clinician consultant for US Food and Drug Administration-designated signs of sepsis. Data and machine learning analysis were performed to explore relationships between different donor features and donor eligibility. Results: A review of the potential cornea donor records revealed that the presence of a greater number of signs of sepsis was not associated with a higher probability of donor ineligibility (P = 0.45). The only single sign of sepsis that was associated with a higher likelihood of donor ineligibility determination was positive blood cultures (P < 0.001). Finally, if the patient's length of hospitalization was less than 24 hours, these potential donors were more likely to be deemed ineligible for cornea donation (P < 0.001). Machine learning analysis revealed length of hospitalization to be the most importantly weighted factor in determining donor eligibility. Conclusions: Based on our analysis of hundreds of medical records over more than a decade, the data suggest that potential cornea donors who 1) have a positive blood culture or 2) have a length of stay of less than 24 hours may be reasonably deemed likely not eligible for donation and not all forwarded to infectious disease consultants or their respective medical director. The results of this study call for further exploration with the collection of larger sample sizes and more representative populations of cornea donors to pursue potential protocols with respect to determining cornea donor eligibility.