Corneal Graft Biology, Engineering and Imaging Laboratory, BiiGC, EA, Federative Institute of Research in Sciences and Health Engineering, Faculty of Medicine, Jean Monnet University, Saint-Etienne, France.
Ophthalmology Department, University Hospital, Saint-Etienne, France.
PLoS One. 2020 May 21;15(5):e0233392. doi: 10.1371/journal.pone.0233392. eCollection 2020.
Fresh corneal donation is essential for basic and preclinical research, but more unknown to public and the medical teams than donation for transplantation: it may raise concerns. We prospectively compared the acceptance rates and the characteristics of targeted corneal donation for research versus donation for transplantation during one year. The Agence de la Biomédecine authorized us to procure fresh corneas targeted for research, only from the donors with medical contraindications for transplantation, in order not to increase grafts shortage. Three nurses from the hospital coordination team of Saint-Etienne University Hospital, obtained consent for research and transplantation in parallel, screening all intra-hospital deaths cases, following standard protocol to check no refusal from families, despite the French opt-out system. They contacted 127 families for research and 244 for transplantation, in 71% of cases by telephone. Consent was obtained in 62% of cases for research and 54% for transplantation (P = 0.135). The main contraindication for transplantation was the cognitive disorders (66%) followed by the blood cancers (8%). This new specific activity, providing new source of fresh corneas for research immediately usable without any eyebank storage steps, didn't reduce the number of corneas procured for transplantation versus previous years (P = 0.998). Donors in the research group were 10 years older (P<0.001) without difference regarding endothelial cell quality (P = 0.071), allowing maximal clinical relevance for protocols using these fresh human scientific corneas provided by targeted donation.
新鲜角膜捐献对于基础和临床前研究至关重要,但公众和医疗团队对此知之甚少,甚至不如捐献用于移植:这可能会引起关注。我们前瞻性地比较了一年中用于研究和移植的目标角膜捐献的接受率和特征。生物医学机构授权我们仅从有移植医学禁忌症的供体中获取用于研究的新鲜角膜,以避免增加移植物短缺。圣艾蒂安大学医院协调团队的 3 名护士,按照标准协议同时获得了研究和移植的同意,检查家庭是否有任何拒绝,尽管法国实行了默认同意制度。他们通过电话联系了 127 个家庭进行研究,244 个家庭进行移植。在 71%的情况下,同意率为 62%用于研究,54%用于移植(P=0.135)。移植的主要禁忌症是认知障碍(66%),其次是血液癌(8%)。这种新的特定活动为研究提供了新鲜角膜的新来源,可立即使用,无需任何眼库储存步骤,与前几年相比,移植获取的角膜数量并没有减少(P=0.998)。研究组的供体年龄大 10 岁(P<0.001),内皮细胞质量无差异(P=0.071),允许使用这些通过目标捐献提供的新鲜人科学角膜进行的协议具有最大的临床相关性。