Horstmann Marie Ella, Al Hariri Mohammad, Grabitz Stephanie D, Bu Julia Bing, Apel Melissa, Pfeiffer Norbert, Wasielica-Poslednik Joanna
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany.
Eye Bank of Rhineland-Palatinate in Mainz, 55131 Mainz, Germany.
Microorganisms. 2023 Sep 26;11(10):2405. doi: 10.3390/microorganisms11102405.
(1) To determine the prevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV) DNA in donor corneas; (2) To evaluate the clinical outcome of the grafts with viral DNA and to compare donors with and without viral DNA.
We analyzed data from all donors and recipients who underwent penetrating keratoplasty (PK) or Descemet membrane endothelial keratoplasty (DMEK) between September 2022 and March 2023. Donor corneoscleral rims and excised recipients' corneal buttons were tested for the presence of HSV-1, HSV-2, VZV, and CMV DNA by polymerase chain reaction (PCR). The results were known 2-3 days after the surgery. We closely followed up on patients whose grafts tested positive for viral DNA. We compared the medical histories of donors with and without viral DNA.
We included 85 corneas from 67 donors. Seven (8.2%) donor corneas tested positive for HSV-1 (n = 3) or VZV (n = 4) DNA. We did not detect any HSV-2 or CMV DNA. In the postoperative follow-up of patients with positive PCR, a graft failure was observed in one and infections in two eyes. Re-operation was necessary in three of these cases (42.9%). Patients without herpes DNA in the donor cornea needed reoperation in 7.7% of the cases. Cultural duration, the cause of the donor's death, and the death-to-explantation interval did not differ significantly between donors with and without viral DNA. Additionally, 3 of the 7 (42.9%) donors with positive PCR were in a septic status at the time of death, compared to 21 of the 78 (26.9%) donors with negative PCR ( = 0.52).
The prevalence of herpes DNA in the donor corneas was 8.2% and thus higher than previously reported. We did not notice any evidence for a donor-to-host transmission, but a higher rate of postoperative complications in recipients of the grafts with viral DNA. The donors with and without herpetic DNA did not differ significantly regarding systemic diagnoses or cultural conditions, but sepsis was more frequent in the group with viral DNA.
（1）确定供体角膜中单纯疱疹病毒1型（HSV-1）和2型（HSV-2）、水痘带状疱疹病毒（VZV）和巨细胞病毒（CMV）DNA的流行率；（2）评估带有病毒DNA的移植物的临床结果，并比较有和没有病毒DNA的供体。
我们分析了2022年9月至2023年3月期间接受穿透性角膜移植术（PK）或Descemet膜内皮角膜移植术（DMEK）的所有供体和受体的数据。通过聚合酶链反应（PCR）检测供体角膜缘和切除的受体角膜纽扣中HSV-1、HSV-2、VZV和CMV DNA的存在情况。术后2-3天得出结果。我们密切随访病毒DNA检测呈阳性的移植物患者。我们比较了有和没有病毒DNA的供体的病史。
我们纳入了来自67名供体的85只角膜。7只（8.2%）供体角膜的HSV-1（n = 3）或VZV（n = 4）DNA检测呈阳性。我们未检测到任何HSV-2或CMV DNA。在PCR检测呈阳性的患者的术后随访中，观察到1例移植物失败，2只眼发生感染。其中3例（42.9%）需要再次手术。供体角膜中无疱疹DNA的患者7.7%需要再次手术。有和没有病毒DNA的供体之间的培养时间、供体死亡原因以及死亡至植片摘取间隔无显著差异。此外，PCR检测呈阳性的7名供体中有3名（42.9%）在死亡时处于败血症状态，而PCR检测呈阴性的78名供体中有21名（26.9%）（P = 0.52）。
供体角膜中疱疹DNA的流行率为8.2%，因此高于先前报道。我们未发现任何供体向宿主传播的证据，但带有病毒DNA的移植物受体术后并发症发生率更高。有和没有疱疹DNA的供体在全身诊断或培养条件方面无显著差异，但病毒DNA组败血症更常见。
