Margo Jordan A, Whiting Martha F, Brown Clayton H, Hoover Caroline K, Munir Wuqaas M
Department of Ophthalmology & Visual Sciences, University of Maryland, Baltimore, Maryland.
University of Maryland School of Medicine, Baltimore, Maryland.
Am J Ophthalmol. 2017 Nov;183:65-70. doi: 10.1016/j.ajo.2017.08.023. Epub 2017 Sep 8.
To determine how chronic obstructive pulmonary disease (COPD) and mechanical ventilation time affect corneal donor endothelial cell density (ECD) and transplant suitability.
Retrospective cohort study.
Setting: Institutional.
Total of 39 679 cornea donor eyes from SightLife Eye Bank between 2012 and 2016. Demographics, death-to-preservation time, ECD, lens status, medical history, time on mechanical ventilation, and suitability for transplantation were included.
ECD and transplant suitability.
Mean ECD was 2733 cells/mm. Mean age was 59 years. COPD affected 34.2% of donors. Mechanical ventilation was required in 35% of donors. Mean ventilation time was 1.3 days. After controlling for covariates, COPD was not found to be associated with poor transplant suitability (P = .22). Ventilation >7 days was associated with poor transplant suitability (P = .04). Donors with COPD and donors who were mechanically ventilated exhibited lower cell counts (P < .001, P < .01, respectively). Longer ventilation led to reduced endothelial cell density: ventilation time >7 days (-46.5 cells/mm, P < .001) and >30 days (-101.4 cells/mm, P = .02). Limitations of the study included the retrospective nature, dataset obtained from a single eye bank, and medical history documentation completed by eye bank technicians.
A high proportion of cornea donors have respiratory disease prior to donation. Ventilation time >7 days affected transplant suitability but the presence of COPD did not. Donors with COPD and donors who were mechanically ventilated had reduced cell counts. Longer ventilation times lead to increased cell loss. The presence of respiratory disease may affect tissue oxygenation and endothelial cell health.
确定慢性阻塞性肺疾病（COPD）和机械通气时间如何影响角膜供体内皮细胞密度（ECD）及移植适宜性。
回顾性队列研究。
研究机构。
2012年至2016年间来自SightLife眼库的39679只角膜供体眼。纳入人口统计学资料、死亡至保存时间、ECD、晶状体状态、病史、机械通气时间及移植适宜性。
ECD及移植适宜性。
平均ECD为2733个细胞/mm²。平均年龄为59岁。34.2%的供体患有COPD。35%的供体需要机械通气。平均通气时间为1.3天。在控制协变量后，未发现COPD与移植适宜性差相关（P = 0.22）。通气时间>7天与移植适宜性差相关（P = 0.04）。患有COPD的供体和接受机械通气的供体的细胞计数较低（分别为P < 0.001，P < 0.01）。通气时间延长导致内皮细胞密度降低：通气时间>7天（-46.5个细胞/mm²，P < 0.001）和>30天（-101.4个细胞/mm²，P = 0.02）。研究的局限性包括回顾性性质、从单一眼库获得的数据集以及由眼库技术人员完成的病史记录。
高比例的角膜供体在捐献前患有呼吸系统疾病。通气时间>7天影响移植适宜性，但COPD的存在不影响。患有COPD的供体和接受机械通气的供体的细胞计数减少。通气时间延长导致细胞损失增加。呼吸系统疾病的存在可能影响组织氧合和内皮细胞健康。
