Madzak Aida, Hjortdal Jesper
Department of Ophthalmology, Aarhus University Hospital, Aarhus C, Denmark.
Cornea. 2018 Oct;37(10):1232-1236. doi: 10.1097/ICO.0000000000001676.
Organ culture is the most common method for preservation of human donor corneas within Europe, and the maximum accepted storage period is typically set to 4 weeks. However, little is known about the fate of prolonged (4+ wks) organ culture storage of donor corneas. The aim of this study was to evaluate the clinical outcomes of corneal grafts preserved from 4 to 7 weeks compared with corneal grafts preserved up to 4 weeks in organ culture medium.
A registry study was performed, identifying 1252 corneal transplantations [Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP)] between February 2008 and November 2015 at Aarhus University Hospital, Denmark. Data were extracted from The Danish Cornea Bank Registry and The Swedish Cornea Registry, which also includes Danish patients. The outcomes evaluated, 2 years after transplantation, were graft function, rebubbling rates in DSAEK surgeries, rejection rates, and endothelial cell density (ECD).
A total of 808 donor corneas were stored for ≤29 days, with a mean preservation time being 20 ± 6 days (mean ± SD, range: 6-29 days). A total of 444 donor corneas were stored for >29 days, with a mean preservation time being 38 ± 7 days (mean ± SD, range: 30-72 days). In both DSAEK (n = 835) and PKP (n = 417), no statistically significant difference was observed in the frequency of graft failure (DSAEK, P = 0.9 and PKP, P = 0.74), rebubbling rates (DSAEK P = 0.07), rejection rates (DSAEK, P = 0.08 and PKP, P = 0.95), or ECD (DSAEK, P = 0.56 and PKP, P = 0.44) between donor corneas cultured for ≤29 days and donor corneas cultured for >29 days.
Corneas stored in organ culture for more than 4 weeks are equally suitable for DSAEK and PKP transplantation as corneas stored in organ culture for up to 4 weeks.
器官培养是欧洲保存人类供体角膜最常用的方法,通常设定的最大可接受储存期为4周。然而,对于供体角膜延长(4周以上)器官培养储存后的命运知之甚少。本研究的目的是评估在器官培养基中保存4至7周的角膜移植与保存至4周的角膜移植的临床结果。
进行了一项登记研究,确定了2008年2月至2015年11月期间在丹麦奥胡斯大学医院进行的1252例角膜移植手术[Descemet膜剥离自动内皮角膜移植术(DSAEK)和穿透性角膜移植术(PKP)]。数据从丹麦角膜库登记处和瑞典角膜登记处提取,后者也包括丹麦患者。评估的移植后2年的结果包括移植功能、DSAEK手术中的再气泡形成率、排斥率和内皮细胞密度(ECD)。
共有808个供体角膜储存≤29天,平均保存时间为20±6天(平均值±标准差,范围:6 - 29天)。共有444个供体角膜储存>29天,平均保存时间为38±7天(平均值±标准差,范围:30 - 72天)。在DSAEK(n = 835)和PKP(n = 417)中,保存≤29天的供体角膜与保存>29天的供体角膜在移植失败频率(DSAEK,P = 0.9;PKP, P = 0.74)、再气泡形成率(DSAEK,P = 0.07)、排斥率(DSAEK,P = 0.08;PKP,P = 0.95)或ECD(DSAEK,P = 0.56;PKP,P = 0.44)方面均未观察到统计学上的显著差异。
在器官培养中储存超过4周的角膜与在器官培养中储存长达4周的角膜同样适合DSAEK和PKP移植。