Background: The realization of tissue donations is bound to a tight timeframe. Depending on the type of tissue, time limits are specified within which the donation must be procured and processed. Otherwise, there is a risk of tissue quality loss with increasing time intervals from cardiovascular arrest. According to the European Directorate for the Quality of Medicines and HealthCare (EDQM) guide, cornea must be procured and processed within 72 h after death. The question arises whether this time interval has an influence on the quality of transplanted tissues and how it affects the accomplishment of tissue donations. Methods: In order to obtain information on this, the numbers of tissue donations in the network of the German Society for Tissue Transplantation (DGFG) were evaluated as a function of the death to retrieval time (DRT) as well as the death to preservation time (DPT). For this purpose, 21,454 database entries of cornea donations made in the period from 2014 to 2018 were included. Results: The results show that nearly 50% of donations realized in the DGFG network could be processed only 48 h or later after cardiovascular death due to the opt-in regulation in Germany. For these donations, there seems to be a higher discard rate compared to donations taken earlier. Nevertheless, there is a transplantation rate for these grafts of more than 65%, which is comparable to average transplantation rates stated in the literature. Conclusion: All corneas finally selected for transplantation must meet the specified quality parameters. Since this naturally also applies to transplants that could only be procured at later time points, it can be concluded that DPT up to 72 h for corneal tissue is adequate and has no influence on the quality of corneas that are ultimately transplanted.

1.
Cursiefen. Hornhauttransplantation - Glänzende Bilanz und viele Perspektiven. Dtsch Ärzteblatt. 2005; 102(45):A3078/A3080. [Guidelines for the procurement of donor corneas and for running an eye corneal bank], (in German) Dtsch Ärzteblatt | 24.01.
2018
| DOI:
2.
Richtlinie zur Gewinnung von Spenderhornhäuten und zum Führen einer Augenhornhautbank, Erste Fortschreibung. Dtsch Arztebl. 2018 Jan. DOI: .
3.
Schroeter
J
,
Maier
P
,
Bednarz
J
,
Blüthner
K
,
Quenzel
M
,
Pruss
A
, et al.
[Procedural guidelines. Good tissue practice for cornea banks]
.
Ophthalmologe
.
2009
Mar
;
106
(
3
):
265
74
.
[PubMed]
0941-293X
4.
Böhnke
M
.
Spendergewebe für die Keratoplastik. Erfahrungsbericht aus der Hamburger Hornhautbank
.
Klin Monatsbl Augenheilkd
.
1991
Jun
;
198
(
6
):
562
71
.
[PubMed]
0023-2165
5.
Uphoff
J
,
Bednarz
J
,
Engelmann
K
.
[Follow-up of endothelial cell density after perforating keratoplasty. Effect of donor and recipient-related factors]
.
Ophthalmologe
.
2001
Jun
;
98
(
6
):
550
4
.
[PubMed]
0941-293X
6.
Ehlers
N
,
Hjortdal
J
,
Nielsen
K
.
Corneal grafting and banking
.
Dev Ophthalmol
.
2009
;
43
:
1
14
.
[PubMed]
0250-3751
7.
Murphy
C
,
Alvarado
J
,
Juster
R
,
Maglio
M
.
Prenatal and postnatal cellularity of the human corneal endothelium. A quantitative histologic study
.
Invest Ophthalmol Vis Sci
.
1984
Mar
;
25
(
3
):
312
22
.
[PubMed]
0146-0404
8.
Joyce
NC
.
Proliferative capacity of corneal endothelial cells
.
Exp Eye Res
.
2012
Feb
;
95
(
1
):
16
23
.
[PubMed]
0014-4835
9.
Keitel
S
. Guide to the quality and safety of tissues and cells for human application, European Committee (Partial Agreement) on Organ Transplantation, 4th ed. Strasbourg: European Directorate for the Quality of Medicines&HealthCare (EDQM),
2019
.
10.
Röck
T
,
Hofmann
J
,
Thaler
S
,
Bramkamp
M
,
Bartz-Schmidt
KU
,
Yoeruek
E
, et al.
Factors that influence the suitability of human organ-cultured corneas
.
Graefes Arch Clin Exp Ophthalmol
.
2016
Jan
;
254
(
1
):
135
41
.
[PubMed]
0721-832X
11.
Sugar
J
,
Montoya
M
,
Dontchev
M
,
Tanner
JP
,
Beck
R
,
Gal
R
, et al.;
Group Cornea Donor Study Investigator Group
.
Donor risk factors for graft failure in the cornea donor study
.
Cornea
.
2009
Oct
;
28
(
9
):
981
5
.
[PubMed]
0277-3740
12.
Patel
SV
,
Diehl
NN
,
Hodge
DO
,
Bourne
WM
.
Donor risk factors for graft failure in a 20-year study of penetrating keratoplasty
.
Arch Ophthalmol
.
2010
Apr
;
128
(
4
):
418
25
.
[PubMed]
0003-9950
13.
Ranjan
A
,
Das
S
,
Sahu
SK
.
Donor and tissue profile of a community eye bank in Eastern India
.
Indian J Ophthalmol
.
2014
Sep
;
62
(
9
):
935
7
.
[PubMed]
0301-4738
14.
Mohamed
A
,
Chaurasia
S
,
Garg
P
.
Outcome of transplanted donor corneas with more than 6 h of death-to-preservation time
.
Indian J Ophthalmol
.
2016
Sep
;
64
(
9
):
635
8
.
[PubMed]
0301-4738
15.
Patel
D
,
Tandon
R
,
Ganger
A
,
Vij
A
,
Lalwani
S
,
Kumar
A
.
Study of death to preservation time and its impact on utilisation of donor corneas
.
Trop Doct
.
2017
Oct
;
47
(
4
):
365
70
.
[PubMed]
0049-4755
16.
Van Meter
WS
,
Katz
DG
,
White
H
,
Gayheart
R
.
Effect of death-to-preservation time on donor corneal epithelium
.
Trans Am Ophthalmol Soc
.
2005
;
103
:
209
22
.
[PubMed]
1545-6110
17.
Slettedal
JK
,
Lyberg
T
,
Ramstad
H
,
Beraki
K
,
Nicolaissen
B
.
Regeneration of the epithelium in organ-cultured donor corneas with extended post-mortem time
.
Acta Ophthalmol Scand
.
2007
Jun
;
85
(
4
):
371
6
.
[PubMed]
1395-3907
18.
Irschick
E
,
Meyer
M
,
Pedross
F
,
Bechrakis
NE
.
Einfluss der Kultur- und Entquellungsdauer auf die Klarheit von transplantierten Hornhäuten
.
Spektrum Augenheilkd
.
2009
;
23
(
4
):
256
64
. 0930-4282
19.
Andersen
J
,
Ehlers
N
.
The influence of donor age and post mortem time on corneal graft survival and thickness when employing banked donor material (A five-year follow-up)
.
Acta Ophthalmol (Copenh)
.
1988
Jun
;
66
(
3
):
313
7
.
[PubMed]
0001-639X
20.
Armitage
WJ
,
Jones
MN
,
Zambrano
I
,
Carley
F
,
Tole
DM
;
NHSBT Ocular Tissue Advisory Group and Contributing Ophthalmologists OTAG Audit Study 12
.
The suitability of corneas stored by organ culture for penetrating keratoplasty and influence of donor and recipient factors on 5-year graft survival
.
Invest Ophthalmol Vis Sci
.
2014
Feb
;
55
(
2
):
784
91
.
[PubMed]
0146-0404
21.
Rahman
I
,
Carley
F
,
Hillarby
C
,
Brahma
A
,
Tullo
AB
.
Penetrating keratoplasty: indications, outcomes, and complications
.
Eye (Lond)
.
2009
Jun
;
23
(
6
):
1288
94
.
[PubMed]
0950-222X
22.
Williams
KA
,
Lowe
M
,
Bartlett
C
,
Kelly
TL
,
Coster
DJ
;
All Contributors
.
Risk factors for human corneal graft failure within the Australian corneal graft registry
.
Transplantation
.
2008
Dec
;
86
(
12
):
1720
4
.
[PubMed]
0041-1337
23.
Fasolo
A
,
Capuzzo
C
,
Fornea
M
,
Franch
A
,
Birattari
F
,
Carito
G
, et al.;
CORTES Study Group
.
Risk factors for graft failure after penetrating keratoplasty: 5-year follow-up from the corneal transplant epidemiological study
.
Cornea
.
2011
Dec
;
30
(
12
):
1328
35
.
[PubMed]
0277-3740
24.
Kaiser
M
.
Risikofaktoren für ein Hornhaut-Transplantatversagen bei perforierenden Keratoplastiken an der Augenklinik der Ludwig-Maximilians-Universität München
Dissertation zum Erwerb des Doktorgrades der Medizin an der Medizinischen Fakultät.
2015
25.
Feizi
S
,
Javadi
MA
,
Ghasemi
H
,
Javadi
F
.
Effect of Donor Graft Quality on Clinical Outcomes After Penetrating Keratoplasty for Keratoconus
.
J Ophthalmic Vis Res
.
2015
Oct-Dec
;
10
(
4
):
364
9
.
[PubMed]
2008-2010
26.
Langenbucher
A
,
Nguyen
NX
,
Seitz
B
.
Predictive donor factors for chronic endothelial cell loss after nonmechanical penetrating keratoplasty in a regression model
.
Graefes Arch Clin Exp Ophthalmol
.
2003
Dec
;
241
(
12
):
975
81
.
[PubMed]
0721-832X
27.
Maier
AK
,
Gundlach
E
,
Schroeter
J
,
Klamann
MK
,
Gonnermann
J
,
Riechardt
AI
, et al.
Influence of the difficulty of graft unfolding and attachment on the outcome in Descemet membrane endothelial keratoplasty
.
Graefes Arch Clin Exp Ophthalmol
.
2015
Jun
;
253
(
6
):
895
900
.
[PubMed]
0721-832X
28.
Schaub
F
,
Enders
P
,
Adler
W
,
Bachmann
BO
,
Cursiefen
C
,
Heindl
LM
.
Impact of donor graft quality on deep anterior lamellar Keratoplasty (DALK)
.
BMC Ophthalmol
.
2017
Nov
;
17
(
1
):
204
.
[PubMed]
1471-2415
29.
Böhringer
D
,
Reinhard
T
,
Spelsberg
H
,
Sundmacher
R
.
Influencing factors on chronic endothelial cell loss characterised in a homogeneous group of patients
.
Br J Ophthalmol
.
2002
Jan
;
86
(
1
):
35
8
.
[PubMed]
0007-1161
30.
Gavrilov
JC
,
Borderie
VM
,
Laroche
L
,
Delbosc
B
.
Influencing factors on the suitability of organ-cultured corneas
.
Eye (Lond)
.
2010
Jul
;
24
(
7
):
1227
33
.
[PubMed]
0950-222X
31.
Gruenert
AK
,
Rosenbaum
K
,
Geerling
G
,
Fuchsluger
TA
.
The influence of donor factors on corneal organ culture contamination
.
Acta Ophthalmol
.
2017
Nov
;
95
(
7
):
733
40
.
[PubMed]
1755-375X
32.
Probst
LE
,
Halfaker
BA
,
Holland
EJ
.
Quality of corneal donor tissue in the greater-than-75-year age group
.
Cornea
.
1997
Sep
;
16
(
5
):
507
11
.
[PubMed]
0277-3740
33.
Linke
SJ
,
Eddy
MT
,
Bednarz
J
,
Fricke
OH
,
Wulff
B
,
Schröder
AS
, et al.
Thirty years of cornea cultivation: long-term experience in a single eye bank
.
Acta Ophthalmol
.
2013
Sep
;
91
(
6
):
571
8
.
[PubMed]
1755-375X
34.
Beck
RW
,
Gal
RL
,
Mannis
MJ
,
Holland
EJ
,
Cavanagh
HD
,
Foulks
GN
, et al.
Is donor age an important determinant of graft survival?
Cornea
.
1999
Sep
;
18
(
5
):
503
10
.
[PubMed]
0277-3740
35.
Hofmann
N
,
Derks
M
,
Börgel
M
,
Engelmann
K
.
[Influence of the donor age on graft survival : is the demographic change also important for corneal tissue donation?]
.
Ophthalmologe
.
2017
May
;
114
(
5
):
440
4
.
[PubMed]
0941-293X
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.