Detection probability of contaminations in organ culture media does not increase between days 3 and 8; therefore, sterility can be tested on day 3. With the recommended follow-up after sterility testing being 7 days, microbiologic release can take place after 10 days of culture. Nevertheless, the testing is not failsafe, and should always be combined with macroscopic inspection of the media.

Corneal dehydration after organ culture seems to be a multifactorial process, which not only depends on osmotic effects of the deswelling compound but also requires the presence of an intact endothelial cell layer.

BackgroundConsent for cornea donation from non–heart-beating donors is often requested by means of telephone interviews with relatives of the deceased. The purpose of this study was to identify the effect of specifically tailored interviewer communications training among other factors related to obtaining consent.MethodsA retrospective analysis of consent requests made by the Aachen Cornea Bank was performed. Interviews were conducted via telephone by 26 ophthalmic residents or fellows in accordance with German and European laws and guidelines. Multiple logistic regression was used to identify factors related to the consent. Results were expressed as odds ratios (OR), 95% confidence interval (95% CI), and Wald P value.ResultsIn 1694 interviews, the overall consent rate was 50.12%. Multivariate analysis identified 4 significant factors associated with the donation decision. Completion of a specific communication training seminar increased odds of consent by 1.533 (95% CI, 1.250-1.880; P < 0.0001). The individual interviewer had an impact on the OR of up to 1.255 (95% CI, 1.113-1.417; P = 0.0002). The odds for consent were inversely correlated with the clinical experience of the interviewer (OR, 0.884; 95% CI, 0.831-0.938; P < 0.0001). The consulted family member was 0.894 times less likely to grant consent for donation with each increase in degree of blood relation (95% CI, 0.849-0.940; P < 0.0001).ConclusionsA telephone interview is effective for obtaining consent for cornea donation. The consent decision may be associated with factors relating to the interviewer as well as the consulted family member. Specific training for cornea bank staff may increase the odds of obtaining consent.

Purpose Varying states of hydration during organ culture and subsequent dehydration of corneas with Dextran prior to transplantation cause endothelial cell damage. Hydroxyethyl starch 130 (HES) has been suggested as a permanent dehydrating agent in serum‐free cornea culture. This study compares corneas stored in a synthetic medium containing HES with corneas stored and dehydrated under standard conditions. Methods Twenty pairs of human donor corneas were cultivated in MEM with antibiotics at 31°C for 16 days (groups A and B) or 28 days (groups C and D, n=10). Media contained 2%FCS in group A and C, and 7.5 % HES 130 plus 1mU/l human insulin in groups B and D. On day 15 or 27, corneas from group A and C were placed in dehydration medium (MEM + antibiotics + 2%FCS + 5% dextran 500). Endothelial cell density and morphology were investigated at the beginning and end of culture. Corneal thickness was assessed by pachymetry. Keratocyte viability was assessed by TUNEL and Annexin V staining. Results Endothelial cell loss was higher in group A (278.5+/‐184.2) vs. B (156.6+/‐154; p=0.0293), and in group C (490+/‐156.3) vs. D (301.8+/‐189.6; p=0.0195), with similar morphology. Final corneal thickness was 882+119µm and 914+119µm in groups A and B, and 889+99µm and 957+87µm in groups C and D, resp. (n.s.). No significant differences were found in TUNEL and Annexin staining. Conclusion The synthetic medium supplemented with HES 130 and insulin improves endothelial cell survival during cornea culture, without adverse effects ion keratocyte viability. It is thus feasible to store donor corneas in fully synthetic medium without the chemically undefined FCS and without the need for dehydration, resulting in increased safety and faster transplant availability.