Cornea Bank Amsterdam, Department of Euro Tissue Bank, Beverwijk, The Netherlands.
Acta Ophthalmol. 2011 Dec;89(8):734-40. doi: 10.1111/j.1755-3768.2009.01805.x. Epub 2009 Dec 21.
To validate tissue quality parameters for donor corneas designated for emergency grafting for corneal graft survival.
In a longitudinal cohort follow-up study, 131 emergency penetrating grafts were studied. Grafts were performed with a pool of organ-cultured donor corneas designated for emergency grafting and prepared for immediate use with all safety tests performed. Assignation criteria were: corneas with a small superficial stromal opacity but meeting all selection criteria for PKP tissue and corneas without stromal opacity, but an endothelial cell density from 1800 to 2300 cells/mm(2) or mild polymegathism or pleomorphism. Cox multivariate regression analysis, Kaplan-Meier survival and log rank test were applied.
Of the 131 keratoplasties, 115 could be followed. One eye was lost during surgery because of an expulsive bleeding. In 15 cases, a conjunctival transplantation finished off the penetrating graft. Corneal graft survival was not significantly related to the presence of PKP quality of the donor endothelium, neither with a cloudy graft nor with endothelial decompensation as the cause of failure. Main risk factors for a failed graft were vascularization of the host cornea (p=0.0001), the presence of a systemic auto immune disease in the recipient (p=0.003) and the disease leading to the (imminent) perforation and emergency graft (p=0.021).
A selected pool of donor corneas designated for emergency grafting that does not interfere with the scheduled procedures allows more efficient and safe use of donor tissue in case of a(n) (imminent) perforation. Corneal graft survival rates justify the criteria for selection.
验证用于紧急移植的供体角膜的组织质量参数，以确保角膜移植的存活率。
在一项纵向队列随访研究中，对 131 例紧急穿透性移植进行了研究。移植采用一组经过器官培养的供体角膜进行，这些角膜被指定用于紧急移植，并经过所有安全测试准备立即使用。分配标准为：角膜浅层基质混浊较小，但符合穿透性角膜移植术（PKP）组织的所有选择标准，或无基质混浊，但内皮细胞密度为 1800 至 2300 个细胞/mm²，或存在轻度多核巨细胞或多形性。应用 Cox 多变量回归分析、Kaplan-Meier 生存分析和对数秩检验。
在 131 例角膜移植中，有 115 例可以进行随访。有 1 只眼在手术中因挤压性出血而丧失。在 15 例病例中，进行了结膜移植以完成穿透性移植。角膜移植的存活率与供体角膜内皮的 PKP 质量、混浊的移植物或内皮失代偿作为失败的原因无关。移植失败的主要危险因素是宿主角膜的血管化（p=0.0001）、受者存在系统性自身免疫性疾病（p=0.003）以及导致（即将）穿孔和紧急移植的疾病（p=0.021）。
选择用于紧急移植的供体角膜池，不会干扰预定的程序，可以在（即将）穿孔的情况下更有效地、安全地利用供体组织。角膜移植的存活率证明了选择标准的合理性。
