Impact of quality assurance on utilization of corneal tissues in a community Eye Bank

Abstract

PurposeTo determine the linkage between Quality Assurance Program (QAP) and increase in utilization of donor corneas at a community Eye Bank.MethodsA donor cornea is defined as utilized when it is used for cornea transplant. Two metrics, utilization rate (UR) and non-utilization rate (NUR), were defined. The Eye Bank implemented QAP from 2011. As a part of QAP, detailed gap analysis of tissue utilization was performed. Four major categories causing non-utilization of recovered corneas were identified. These categories were poor “Tissue Quality”, “Seropositive” donor blood sample, “Medical History” of donor, and donor “Blood Sample Issues.” The years 2008–2011 were labelled the pre-intervention period, and the years 2012–2017 were labelled the post-intervention period. Annual UR and annual NUR for the four categories of non-utilization from the pre and the post-intervention periods were statistically compared.ResultsIn the pre-intervention period, the Eye Bank recovered 1425 donor corneas in total and transplanted 762. In the post-intervention period, the Eye Bank recovered 6661 corneas in total and transplanted 4393. The UR improved from 53.47% (762/1425) in the pre-intervention period to 65.95% (4393/6661) in the post-intervention period (P < 0.001). NUR in “Tissue Quality” category decreased from 34.32% to 29.7% from the pre to the post-intervention period (P < 0.001). NUR in “Blood Sample Issues” category reduced from 3.23% to 0.32% from the pre to the post-intervention period (P < 0.001). NUR in “Medical History” category decreased from 5.68% to 0.33% from the pre to the post-intervention period (P < 0.001).ConclusionsThe study indicates that QAP improves UR of recovered corneas. In countries with a shortage of donor corneas, increasing utilization of recovered corneas can lead to an increase in corneal transplants. Implementation of QAP at the Eye Bank can be a means of achieving this outcome.

Trends in Corneal Transplantation and Characteristics of Donors in the Chongqing Eye Bank, China: A Retrospective Study, 1999–2018

“…Of the 3,910 corneal tissues acquired by our eye bank, 2,540 were finally used for keratoplasty. This utilization rate is similar to that seen in India and the United States (24)(25)(26). The leading reason why a donated cornea could not be used in our eye bank was due to poor corneal quality, which is similar to what was recently reported in India (24).…”

“…This utilization rate is similar to that seen in India and the United States (24)(25)(26). The leading reason why a donated cornea could not be used in our eye bank was due to poor corneal quality, which is similar to what was recently reported in India (24). The report from India proposed a quality assurance program (QAP) for increasing corneal utilization; such a program would introduce high-level scrutiny of wasted donated tissues, and the authors suggest that such a QAP would improve the corneal utilization rate.…”

How Implementing a Quality Management System at the LIONS Eye Bank Saar-Lor-Lux, Trier/Western Palatinate from 2006 to 2016 Impacted the Rate and Reasons for Discarding Human Organ-Cultured Corneas

“…As a result, there is an urgent need for measures which could help reduce this rate of discarded cornea tissues. Establishing a QM system could help improve not only the standardisation of the processes in an eye bank but also the careful training of the eye bank staff, thus increasing the number of cornea tissues available for transplantation [10]. In addition to the structural standardisation of workflows and treatment protocols, the main component of a functioning QM system is the continuous improvement of its outcomes [11,12].…”

“…Dies bedeutet eine Reduktion der Verwerfungsrate von 46,5 auf 34 %, was den in der hier vorliegenden Studie errechneten Raten sehr ähnlich ist. Die Verwerfung aufgrund mangelnder Gewebequalität reduzierte sich von 34,3 auf knapp 30 %, die Verwerfung aufgrund der Serologie sank von 3,2 auf 0,3 % und die Verwerfung aufgrund der medizinischen Kontraindikationen sank ebenfalls von 5,7 auf 0,3 % [10].…”

“…Maßnahmen, die zur Minderung dieser Verwerfungsrate beitragen können, sind demzufolge dringend erforderlich. Die Etablierung eines QM-Systems könnte zu einer verbesserten Standardisierung der Prozesse in einer Hornhautbank und einer besonders sorgfältigen Ausbildung der Hornhautbankmitarbeiter beitragen und somit die Anzahl der Gewebe, die für eine Transplanta-tion zur Verfügung stehen, erhöhen [10]. Zum Hauptbestandteil eines funktionierenden QM-Systems gehört neben der strukturellen Vereinheitlichung der Arbeits-und Behandlungsabläufe auch die stetige Verbesserung der Ergebnisse [11,12].…”