Almeida Hirlana Gomes, Kara-José Newton, Hida Richard Yudi, Kara-Junior Newton
Department of Ophthalmology (H.G.A., N. Kara-José, R.Y.H., N. Kara-Junior), School of Medicine (Hospital das Clínicas of da Universidade de São Paulo- São Paulo- HC-USP), University of São Paulo, São Paulo, Brazil; and Department of Ophthalmology (R.Y.H.), Santa Casa de São Paulo, São Paulo, Brazil.
Eye Contact Lens. 2018 Nov;44 Suppl 2:S376-S381. doi: 10.1097/ICL.0000000000000554.
To analyze 15-year of corneal transplant in Brazil.
Cross-sectional, retrospective, observational, and analytical study, between available data from the Brazilian Transplant Registry (January 2002-December 2016), collected by the Brazilian Association of Organ Transplantation was performed. The variables analyzed per year were number of corneal transplants, corneal transplants per million people (pmp), corneal transplant teams, and individuals on the waiting list for corneal transplants. Quantitative variables were expressed by their respective values. To verify the relationship of time with the variables, the Spearman correlation test was applied, adopting P<0.05 for rejection of the null hypothesis.
Evaluation of the data from 2002 to 2016 revealed an increase in number of (1) corneal transplants (4,976-14,534-approximately 292% in 15 years; P<0.0001); (2) corneal transplants pmp (29.4-71.1 pmp; P<0.0001); (3) productivity of corneal transplants teams (40.1-79 transplants by each team per year; P=0.067); (4) effectiveness in meeting the Brazilian population demand for corneal transplants per year (18.2%-57.0%; P<0.0001); (5) potential donors (P<0.0001), effective donors (P<0.0001), and nondonors (P<0.0001). There was a reduction in the number of patients on the waiting list (19,189-10,923; P=0.056).
Despite the progress in the last decade, the number of corneal transplants in Brazil cannot meet the growing population demand. Thus, this study suggests the implementation of more effective public policies of corneal transplants in Brazil, to minimize disparities in national territory, adequately meet the population demand, and reduce the time in waiting lists for corneal transplants.
分析巴西15年的角膜移植情况。
进行横断面、回顾性、观察性和分析性研究，数据来源于巴西器官移植协会收集的巴西移植登记处（2002年1月至2016年12月）的可用数据。每年分析的变量包括角膜移植数量、每百万人口角膜移植数（pmp）、角膜移植团队以及角膜移植等待名单上的个体。定量变量用各自的值表示。为验证时间与变量的关系，应用Spearman相关性检验，采用P<0.05来拒绝原假设。
对2002年至2016年数据的评估显示：（1）角膜移植数量增加（4976例至14534例，15年增长约292%；P<0.0001）；（2）每百万人口角膜移植数增加（29.4 pmp至71.1 pmp；P<0.0001）；（3）角膜移植团队的生产力提高（每个团队每年40.1例至79例移植；P=0.067）；（4）每年满足巴西人口角膜移植需求的有效性提高（18.2%至57.0%；P<0.0001）；（5）潜在捐赠者（P<0.0001）、有效捐赠者（P<0.0001）和非捐赠者（P<0.0001）数量增加。等待名单上的患者数量减少（19189例至10923例；P=0.056）。
尽管过去十年有进展，但巴西的角膜移植数量仍无法满足不断增长的人口需求。因此，本研究建议在巴西实施更有效的角膜移植公共政策，以尽量减少国内差距，充分满足人口需求，并减少角膜移植等待名单上的时间。
