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J Szaflik, I Grabska-Liberek, M Brix-Warzecha
Ann Transplant 2003; 8(2): 28-33
To examine the effect of various factors such as: donor's age, cause ofdeath, time between death and preservation and duration of preservation on the morphological qualityof corneas used for Penetrating Keratoplasty (PKP). Our purpose was to assess the role of the above factorsinfluencing the corneal overall rating and endothelial cell density. The present data regarding the donor'sage and time between death and preservation of corneas obtained from eye banks belonging to the EuropeanEye Bank Association and Polish eye banks were compared. Corneoscleral buttons and data concerning donorswere obtained by eye bank technicians and collected in Warsaw Eye Bank in the years 1996-2002. The qualityof the corneas recovered was evaluated by means of slit lamp Nikon NS-IV and specular microscope KONAN.Cardiorespiratory failure and cardiac arrest were the most frequent cause of the donors' death. In manycases donors with confirmed brain death who were given the corneas, were also donors of internal organslike heart, kidneys, pancreas and liver. The number of donors with disseminated neoplasm disease--completedisadvantage for removing corneas increased during the eye bank activity. The epithelial and endotheliallayers sometimes underwent mechanical trauma in the group of donors because of sudden death. From 1996to 2002 more than 50% of the donors were over 60 years of age. There were many problems with receivingcorneas from younger donors. The overall rating tissues which were obtained in a very short time afterdeath (to 5 hours) was higher (Excellent and Very Good) compared with corneas removed 8-12 hours afterthe donor's death. The increasing percentage of endothelial cell loss was observed in all the corneasafter about 7 days of preservation in the medium. The mean endothelial cell density slightly decreasedwith donor's age, but its suggested range of the factors possibility of finding the corneas with highnumber of endothelial cell density both in younger and older donors. The average time from death to preservationwas similar in eye banks preserving corneas at +4 degrees C (8-10 hours) compared with eye banks usingmainly the organ culture method. The rating of the morphological state of corneas suitable for PKP dependson the time between death and preservation, donor's age, cause of death and time of preservation of corneas.Corneas obtained shortly after the donor's death showed a higher endothelial cell density and betteroverall rating than those removed after relatively longer period after the donor's death. An increasingpercentage of endothelial cell loss was observed after 7 days of preservation independent of other factors.