Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
National Eye Bank of Taiwan, Ministry of Health and Welfare, Taipei, Taiwan.
Br J Ophthalmol. 2019 Aug;103(8):1030-1034. doi: 10.1136/bjophthalmol-2018-312816. Epub 2018 Oct 15.
This study examined whether corneas from bacteremic donors could be used for corneal transplant.
Corneas donated to the National Eye Bank of Taiwan between 1 January 2014 and 30 June 2017 were included in this study. All the corneas had corneoscleral rim cultures during the retrieval process and were hypothermic preserved in the Optisol-GS storage medium. A microbial work-up flow chart was used for the sterility check of all grafts. Bacteremic donors were defined as those whose last blood culture before corneal donation was positive. The microbial contamination rates, the endothelial cell densities, the tissue utility rates and early complications after transplants were compared between the corneas from bacteremic versus non-bacteremic donors.
697 corneas from 356 donors were analysed, 70 of which were from bacteremic donors. The microbial contamination rates of the corneas from bacteremic and non-bacteremic donors (7.1% vs 9.1%)(p=0.30) were close. None of the contaminated corneas grew the same bacterial strains as those from their blood cultures. The corneas from bacteremic donors and non-bacteremic donors have similar endothelial cell densities (2931±297 cells/mm vs 2903 ± 470 cells/mm) (p=0.63). Corneas from bacteremic and non-bacteremic donors shared a similar utility rate (98.6% vs 99.4%)(p=0.41). None of the corneas caused infectious complications after transplants.
Our study showed that corneas from bacteremic and non-bacteremic donors have equally low contamination rates and are of the same quality in terms of endothelial cell density and safety.
本研究旨在探讨菌血症供体的角膜是否可用于角膜移植。
本研究纳入了 2014 年 1 月 1 日至 2017 年 6 月 30 日期间捐赠给台湾国家眼科银行的角膜。所有角膜在采集过程中均进行了角巩缘培养，并在 Optisol-GS 储存液中低温保存。所有移植物的无菌检查均采用微生物工作流程图表进行。菌血症供体定义为角膜捐献前最后一次血培养阳性的供体。比较了菌血症供体和非菌血症供体角膜的微生物污染率、内皮细胞密度、组织利用率和移植后的早期并发症。
对 356 名供体的 697 个角膜进行了分析，其中 70 个来自菌血症供体。菌血症和非菌血症供体角膜的微生物污染率（7.1% vs 9.1%）（p=0.30）相近。没有一个受污染的角膜与血培养相同的细菌菌株。菌血症供体和非菌血症供体角膜的内皮细胞密度相似（2931±297 个细胞/mm vs 2903 ± 470 个细胞/mm）（p=0.63）。菌血症和非菌血症供体角膜的利用率相似（98.6% vs 99.4%）（p=0.41）。所有角膜在移植后均未发生感染性并发症。
本研究表明，菌血症和非菌血症供体的角膜污染率同样较低，在内皮细胞密度和安全性方面质量相同。
