Cornea procurement from very old donors: post organ culture cornea outcome and recipient graft outcome
| Autor: | J L Pugniet, P. Gain, Gilles Thuret, C. Chiquet, Jean Maugery, J J Colpart, Sophie Acquart, P. Rizzi, J C Le Petit |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Visual acuity Tissue and Organ Procurement Adolescent medicine.medical_treatment Organ culture Corneal Diseases Cornea Corneal Transplantation Cellular and Molecular Neuroscience Organ Culture Techniques Epidemiology medicine Humans Prospective Studies Prospective cohort study Corneal transplantation Aged Aged 80 and over business.industry Endothelium Corneal Graft Survival Age Factors Middle Aged Clinical Science Sensory Systems eye diseases Surgery Endothelial cell density Ophthalmology medicine.anatomical_structure Treatment Outcome Graft survival Female sense organs medicine.symptom business Keratoplasty Penetrating |
| Zdroj: | The British journal of ophthalmology. 86(4) |
| ISSN: | 0007-1161 |
| Popis: | Aim: To study the suitability of corneas from very old donors for graft after banking and their clinical and endothelial outcomes in recipients. Methods: 419 corneas stored in organ culture were divided into group 1, donors under 85 years (330 corneas) and group 2, “very old” donors aged 85 years and over (89 corneas). Endothelial cell density (ECD) before and after organ culture, discard rate before and after storage, and clinical and endothelial outcomes of the 196 penetrating keratoplasties (PKP) (158 in group 1 and 38 in group 2) were compared in a prospective longitudinal study. Results: Initial ECD was lower in group 2 than in group 1 and elimination for low ECD was more frequent in group 2 (respectively 38% v 20.2%, p=0.001). At the end of storage, because very old corneas lost fewer ECs than younger ones (respectively 4.2% v 9.5%, p=0.022), ECD was comparable between the two groups. The corneas of very old donors had a poorer macroscopic appearance at procurement and during surgery. Despite this, in grafted patients, overall graft survival in groups 1 and 2 (respectively 87.4% v 80.6%, p=0.197), visual acuity, and ECD did not differ at completion of the study (mean follow up 25 months). Conclusion: This study suggests that endothelial cell count during banking ensures that functional and cellular results of PKPs are not dramatically influenced by very old donor age. Considering Europe's ageing population, the very elderly should not be deemed off limits for corneal procurement. |
| Databáze: | OpenAIRE |
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