Influence of time to procurement, incubation and release of organ cultured donor corneas on graft failure after Descemet Stripping Automated Endothelial Keratoplasty

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  • Niels Gram, Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Anders Shehab, Hospital Pharmacy, Aarhus University Hospital, Aarhus
  • ,
  • Anders Ivarsen
  • Jesper Hjortdal

PURPOSE: The aim of the present study was to investigate whether the time from death to procurement, to preservation or the storage time of donor corneas preserved in organ culture influenced the clinical outcome of patients undergoing Descemet stripping automated endothelial keratoplasty (DSAEK) for Fuchs endothelial keratoplasty.

METHODS: We conducted a registry-based study on 776 patients undergoing DSAEK. Data on time from donor death to cornea retrieval (DRT), time from death to preservation (DPT), the preservation time and donor cornea characteristics: age, sex and endothelial cell density (ECD) at the time of release for surgery, were extracted from The Danish Cornea Bank Registry. Data on recipient follow-up were collected from a corneal graft registry. The primary outcome was presence of graft failure within a period from 2 months to 2 years after surgery. Secondary outcomes were DRT, DPT, ECD ≤2300 and gender mismatch between donor and recipient.

RESULTS: Graft failure occurred in 26 patients. The mean preservation time for failed grafts was 34.1 ± 10.0 days (mean ± SD) and 27.3 ± 10.6 days (mean ± SD) for the clear, functional grafts at the 2-year follow-up. A preservation time of >29 days compared with ≤29 days was associated with a lower survival (HR 2.33, 95% CI on 1.06-5.14, p = 0.036) and an increased risk of graft failure (RR 1.53, 95% CI on 1.11-2.10, p = 0.009). For the secondary outcome variables, no difference in the risk of graft failure was observed and did not appear to impact the survival rate of DSAEK patients.

CONCLUSION: Preservation time of donor cornea was associated with graft survival and a prolonged preservation time of more than 4 weeks seemed to lower the 2-year survival.

Original languageEnglish
JournalActa Ophthalmologica
Publication statusE-pub ahead of print - 28 Jul 2021

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© 2021 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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