Cleator G M, Klapper P E, Dennett C, Sullivan A L, Bonshek R E, Marcyniuk B, Tullo A B
Department of Pathological Sciences, Medical School, University of Manchester, U.K.
Cornea. 1994 Jul;13(4):294-304. doi: 10.1097/00003226-199407000-00003.
Three corneoscleral discs (from two donors) underwent subtotal endothelial loss during routine "long-term" organ culture storage. Laboratory studies of these corneas revealed evidence of herpes simplex virus (HSV) infection. The fellow cornea from one of the donors had been issued for transplant to a patient with keratoconus. Deterioration of the graft was noted 5 days after surgery; the disc was removed at 2 months and was shown to be infected with HSV. In an experiment designed to simulate initial "cleansing" of donor globes, 0.1% polyvinylpyrolidone-iodine protected cells from infection with HSV. It was concluded that the detection of HSV in these corneas could not be explained by external contamination of the ocular surface. Furthermore, culture of conjunctival and pharangeal swabs taken from 47 consecutive donors confirmed that HSV is rarely isolated at or around the time of death. Five pairs of donor corneas destined for use in transplantation were selected at random and investigated for the presence of HSV. HSV DNA was detected by polymerase chain reaction (PCR) in tissue from two of the corneal donors. Sequential stepwise sectioning suggested that HSV DNA when present was distributed in discrete foci within the cornea. These observations suggest that HSV infection may be a cause of severe endothelial loss during corneal organ culture and possibly provide an explanation for some "failures" of corneal grafting.
三个角膜缘组织块（来自两名供体）在常规“长期”器官培养保存过程中发生了部分内皮细胞丢失。对这些角膜的实验室研究显示有单纯疱疹病毒（HSV）感染的证据。其中一名供体的另一只角膜已被用于移植给一名圆锥角膜患者。术后5天发现移植片恶化；2个月时取出组织块，显示感染了HSV。在一项旨在模拟对供体眼球进行初始“清洁”的实验中，0.1%的聚乙烯吡咯烷酮碘可保护细胞免受HSV感染。得出的结论是，这些角膜中HSV的检测不能用眼表的外部污染来解释。此外，对47名连续供体的结膜和咽部拭子进行培养证实，在死亡时或死亡前后很少分离出HSV。随机选择五对用于移植手术的供体角膜，检测其中HSV的存在情况。通过聚合酶链反应（PCR）在两名角膜供体的组织中检测到了HSV DNA。连续逐步切片显示，HSV DNA如果存在，在角膜内呈离散病灶分布。这些观察结果表明，HSV感染可能是角膜器官培养过程中严重内皮细胞丢失的一个原因，并且可能为一些角膜移植“失败”提供一种解释。
