Trigaux Céline, Salla Sabine, Schroeter Jan, Tourtas Theofilos, Thomasen Henning, Maier Philip, Hellwinkel Olaf J C, Wittmershaus Ilka, Merz Patrick R, Seitz Berthold, Nölle Bernhard, Schrage Norbert, Roters Sigrid, Apel Melissa, Gareiss-Lok Andrea, Uhlig Constantin E, Thaler Sebastian, Raber Florian, Kampik Daniel, Geerling Gerd, Menzel-Severing Johannes
Department of Ophthalmology, University of Düsseldorf, Düsseldorf, Germany.
Department of Ophthalmology, RWTH University Aachen, Aachen, Germany.
Curr Eye Res. 2021 May;46(5):666-671. doi: 10.1080/02713683.2020.1828487. Epub 2020 Oct 4.
Since the beginning of the COVID-19 pandemic there has been some debate regarding the risk of transmission through tissue transplantation and tissue banking processes.
To analyze the changes that SARS-CoV-2 has caused regarding the harvesting of corneal donor tissue and eye bank activities in Germany.
A questionnaire was provided to 26 eye banks in Germany, consisting of questions about adaptations made in the screening of potential donors and the harvesting of corneal tissue following the pandemic spread of SARS-CoV-2.
Eighteen eye banks actively reduced recruitment of donors and two banks ceased all activity. Additional diagnostic screening was performed in eight banks, using conjunctival swabs and/or nasopharyngeal swabs. In six eye banks, additional protective measures, such as FFP2 masks and/or facial shields, were implemented. Overall, a mean reduction in the number of obtained donor tissues of 17% was observed.
Conjunctival and/or nasopharyngeal swabs of donors have been implemented by a minority. Reasons for not performing additional tests may be moderate sensitivity and lack of validation for postmortem use of RT-PCR testing. Also, the hazard of SARS-CoV-2 entering the corneal donor pool with subsequent transmission might be perceived as theoretical. Face shields provide a sufficient barrier against splash and splatter contamination but may be insufficient against aerosols. Additional face masks would provide support against aerosols, but it remains debatable if corneal harvesting can be considered an aerosol-producing procedure. In the future we expect to see changes in current guidelines because of a surge in scientific activities to improve our understanding of the risks involved with cornea donation in the COVID-19 pandemic, and because current practice may reduce the availability of donor corneas due to new exclusion criteria while the demand remains unchanged.
自新冠疫情开始以来，关于通过组织移植和组织库流程传播的风险一直存在一些争论。
分析严重急性呼吸综合征冠状病毒2（SARS-CoV-2）在德国角膜供体组织采集和眼库活动方面所引起的变化。
向德国的26家眼库发放了一份问卷，其中包括关于在SARS-CoV-2大流行传播后对潜在供体进行筛查以及角膜组织采集所做调整的问题。
18家眼库积极减少了供体招募，两家眼库停止了所有活动。8家眼库使用结膜拭子和/或鼻咽拭子进行了额外的诊断性筛查。6家眼库实施了额外的防护措施，如佩戴FFP2口罩和/或面罩。总体而言，观察到获得的供体组织数量平均减少了17%。
少数眼库对供体进行了结膜和/或鼻咽拭子检测。不进行额外检测的原因可能是敏感性一般以及逆转录聚合酶链反应（RT-PCR）检测在死后使用时缺乏验证。此外，SARS-CoV-2进入角膜供体库并随后传播的风险可能被认为是理论上的。面罩可提供足够的屏障防止飞溅和泼溅污染，但可能不足以抵御气溶胶。额外佩戴口罩将有助于抵御气溶胶，但角膜采集是否可被视为产生气溶胶的操作仍存在争议。未来，由于科学活动激增以增进我们对新冠疫情期间角膜捐赠相关风险的理解，并且由于当前做法可能因新的排除标准而减少供体角膜的可用性，而需求保持不变，我们预计现行指南将会有所变化。
