Palamar Melis, Degirmenci Cumali, Sertoz Ruchan, Aydemir Sohret, Egrilmez Sait, Yagci Ayse
From the Department of Ophthalmology, Ege University Faculty of Medicine, Izmir, Turkey.
Exp Clin Transplant. 2017 Dec;15(6):685-688. doi: 10.6002/ect.2015.0374. Epub 2016 Jul 22.
Our objective was to evaluate the serologic positivity of cornea donors and microbiologic positivity of cornea storage media at the Ege University Tissue and Cornea Bank, Izmir, Turkey.
We retrospectively investigated the serologic blood sample and microbiological culture media analysis results of all cornea donors at Ege University Tissue and Cornea Bank between 2007 and 2015 with reference to age, sex, and cause of death of each donor.
Mean age of the 955 deceased donors was 43.19 ± 15.89 years (range, 2-65 y). The mean postmortem time to blood sample removal and excision of the cornea tissue was 8.4 hours (range, 4-12 h). Serologic analyses showed that 855 donors (89.5%) were seronegative. The remaining donors were seropositive for hepatitis B (54 donors; 5.7%), human immunodeficiency (27 donors; 2.8%), hepatitis C (14 donors; 1.5%), and syphilis (5 donors; 0.5%) virus infections. Microbiologic analyses of the storage media were negative, with no microorganisms shown in 855 samples (89.5%). Candida species (32 donors; 3.4%), Escherichia coli (14 donors; 1.5%), Pseudomonas aeruginosa (11 donors; 1.2%), methicillin-resistant Staphylococcus aureus (11 donors; 1.2%), Enterobacter species (11 donors; 1.2%), Klebsiella pneumoniae (7 donors; 0.7%), Acinetobacter baumannii (6 donors; 0.6%), Proteus species (5 donors; 0.5%), and Corynebacterium species (3 donors; 0.3%) were the detected microorganisms in the infected storage media.
False-positive serologic results among cornea donors were high. The incidence of false-positive results might be decreased by earlier blood removal from deceased donors and testing of all potential donors in intensive care units. Although rare, endophthalmitis after keratoplasty might be a devastating problem. In addition to serologic testing, microbiologic analyses of cornea storage media before transplant may be an effective way to prevent postoperative infectious complications.
我们的目的是评估土耳其伊兹密尔艾杰大学组织与角膜库中角膜供体的血清学阳性率以及角膜保存介质的微生物学阳性率。
我们回顾性研究了2007年至2015年间艾杰大学组织与角膜库所有角膜供体的血清学血样和微生物培养介质分析结果，并参考了每个供体的年龄、性别和死亡原因。
955名已故供体的平均年龄为43.19±15.89岁（范围为2至65岁）。采集血样和切除角膜组织的平均死后时间为8.4小时（范围为4至12小时）。血清学分析显示，855名供体（89.5%）血清学阴性。其余供体分别为乙型肝炎血清学阳性（54名供体；5.7%）、人类免疫缺陷病毒血清学阳性（27名供体；2.8%）、丙型肝炎血清学阳性（14名供体；1.5%）和梅毒血清学阳性（5名供体；0.5%）。保存介质的微生物学分析结果为阴性，855份样本（89.5%）未显示有微生物。在受感染的保存介质中检测到的微生物有念珠菌属（32名供体；3.4%）、大肠杆菌（14名供体；1.5%）、铜绿假单胞菌（11名供体；1.2%）、耐甲氧西林金黄色葡萄球菌（11名供体；1.2%）、肠杆菌属（11名供体；1.2%）、肺炎克雷伯菌（7名供体；0.7%）、鲍曼不动杆菌（6名供体；0.6%）、变形杆菌属（5名供体；0.5%）和棒状杆菌属（3名供体；0.3%）。
角膜供体中血清学假阳性结果较高。通过更早地从已故供体采集血样以及对重症监护病房的所有潜在供体进行检测，可能会降低假阳性结果的发生率。尽管罕见，但角膜移植术后眼内炎可能是一个毁灭性的问题。除血清学检测外，移植前对角膜保存介质进行微生物学分析可能是预防术后感染并发症的有效方法。
