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Reappraisal of the suitability of corneas from bacteremic donors for use in corneal transplants
  1. Hsiao-Sang Chu1,2,3,
  2. Chun-Ting Lai1,
  3. Yu-Chih Hou1,
  4. Hsin-Yu Liu1,2,
  5. I-Jong Wang1,
  6. Wei-Li Chen1,
  7. Chung-Liang Shih4,
  8. Fung-Rong Hu1,2
  1. 1 Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
  2. 2 National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei, Taiwan
  3. 3 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
  4. 4 Department of Medical Affairs, Ministry of Health and Welfare, Taipei, Taiwan
  1. Correspondence to Professor Fung-Rong Hu; fungronghu{at}ntu.edu.tw

Abstract

Background This study examined whether corneas from bacteremic donors could be used for corneal transplant.

Methods Corneas donated to the National Eye Bank of Taiwan between 1 January 2014 and 30 June 2017 were included in this study. All the corneas had corneoscleral rim cultures during the retrieval process and were hypothermic preserved in the Optisol-GS storage medium. A microbial work-up flow chart was used for the sterility check of all grafts. Bacteremic donors were defined as those whose last blood culture before corneal donation was positive. The microbial contamination rates, the endothelial cell densities, the tissue utility rates and early complications after transplants were compared between the corneas from bacteremic versus non-bacteremic donors.

Results 697 corneas from 356 donors were analysed, 70 of which were from bacteremic donors. The microbial contamination rates of the corneas from bacteremic and non-bacteremic donors (7.1% vs 9.1%)(p=0.30) were close. None of the contaminated corneas grew the same bacterial strains as those from their blood cultures. The corneas from bacteremic donors and non-bacteremic donors have similar endothelial cell densities (2931±297 cells/mm2 vs 2903 ± 470 cells/mm2) (p=0.63). Corneas from bacteremic and non-bacteremic donors shared a similar utility rate (98.6% vs 99.4%)(p=0.41). None of the corneas caused infectious complications after transplants.

Conclusion Our study showed that corneas from bacteremic and non-bacteremic donors have equally low contamination rates and are of the same quality in terms of endothelial cell density and safety.

  • bacteremia
  • sepsis
  • corneal transplant
  • corneal donation
  • eye bank

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Footnotes

  • Contributors Chu H-S and Hu F-R conceived and designed the study. Chu H-S, Lai C-T, Hou Y-C, Liu H-Y, Wang I-J and Chen W-L collected the data. Chu H-S and Lai C-T reviewed the literature. Chu H-S performed data analysis and manuscript writing. Shih C-L was the supervisor of the study. Hu F-R interpreted the data and edited the final version of the manuscript. All authors read and approved the final version of this manuscript.

  • Funding This study was funded by the Ministry of Health and Welfare (grants no. TORSC1031006, TORSC1041130, TORSC1051220).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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