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新冠疫情爆发对角膜捐献者供应的早期影响:警示与建议

Early Impact of COVID-19 Outbreak on the Availability of Cornea Donors: Warnings and Recommendations.

作者信息

Toro Mario, Choragiewicz Tomasz, Posarelli Chiara, Figus Michele, Rejdak Robert

机构信息

Department of General Ophthalmology, Medical University of Lublin, Lublin, Poland.

Faculty of Medical Sciences, Collegium Medicum Cardinal Stefan Wyszyński University, Warsaw, Poland.

出版信息

Clin Ophthalmol. 2020 Sep 25;14:2879-2882. doi: 10.2147/OPTH.S260960. eCollection 2020.

Abstract

Keratoplasty is one of the irreplaceable treatment options for corneal diseases. Currently, there is no evidence to substantiate that harvested corneal grafts from COVID-19 patients can contain SARS-CoV-2 virus and lead to a systemic infection. Although the risk of transmission through corneal stromal tissue is low, it potentially exists. Lack of clinical data, unclear potential of donor-derived infection and non-established recommendations for transplantation during the COVID-19 pandemic have resulted in a dramatic reduction in the number of keratoplasty and cornea donors at ophthalmology departments and eye banks. To eliminate the risk of infection of recipients and medical personnel, we suggest that the blood samples of all donors should be screened with RT-PCR tests and nasopharyngeal swabs should be taken. In addition, a chest CT scan should be performed if the circulation is maintained. Moreover, the donors' clinical and epidemiological medical history must be screened for typical symptoms and potential contact with SARS-CoV-2 carriers to reduce the risk of transmission. The Guidelines of the Eye Bank Association of America (EBAA), Global Alliance of Eye Bank Associations (GAEBA) and European Association of Tissue Banks provide useful recommendations to eliminate the risk of transmission according to previous experiences based on similar viruses.

摘要

角膜移植术是治疗角膜疾病不可替代的治疗选择之一。目前,没有证据证实从新冠肺炎患者获取的角膜移植物会含有严重急性呼吸综合征冠状病毒2(SARS-CoV-2)病毒并导致全身感染。虽然通过角膜基质组织传播的风险较低,但这种可能性是存在的。缺乏临床数据、供体源性感染的潜在风险不明以及在新冠肺炎大流行期间尚未确立移植建议,导致眼科科室和眼库的角膜移植术数量和角膜供体数量大幅减少。为消除受者和医务人员的感染风险,我们建议对所有供体的血液样本进行逆转录聚合酶链反应(RT-PCR)检测,并采集鼻咽拭子。此外,如果仍有循环,应进行胸部CT扫描。此外,必须筛查供体的临床和流行病学病史,以查找典型症状以及与SARS-CoV-2携带者的潜在接触情况,以降低传播风险。美国眼库协会(EBAA)、全球眼库协会联盟(GAEBA)和欧洲组织库协会的指南根据以往基于类似病毒的经验,提供了消除传播风险的有用建议。

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