<p>Donor Profile, Tissue Evaluation and Comparison of Voluntary and Motivated Corneal Donation in Nepal Eye Bank</p>

Abstract

Purpose: Corneal problems is one of the major causes of blindness in developing countries like Nepal. This study intended to analyze donor and tissue profile of Nepal Eye Bank (NEB). Material and Methods: This was a cross-sectional descriptive type study. Data of corneal tissues collected by NEB from January 2015 to December 2016 were used in the study. Data collected were demographic profile, cause of death, type of corneal donation (whether voluntary or motivated), quality and utilization of tissues. A comparison was made between voluntary and motivated donors. Results: 1244 corneal tissues were retrieved from 639 donors. Mean age of donors was 49.4 years. 57.7% of the donors were male. There were almost equal number of donor deaths due to cardiovascular disease, 27.2%, and respiratory disease, 26.7%, followed by hanging, 17.8%. Majority of donors were motivated (n = 561, 87.7%). Mean death to preservation time was 5.79 hours (hrs). Of the harvested corneas, 1040 (83.6.%) were suitable for transplant with a mean endothelial cell count of 2850 ± 520 cells/mm 2 ; 16.4% were of poor tissue quality and 2.7% were seropositive. 76.2% of total tissues were of optical quality. Utilization rate of transplantable tissues was 97%. Tissues from motivated donors were significantly "younger" (p=0.0001), had better endothelial count (p=0.0001), and were of better quality (p=0.026) than those from voluntary donors. Conclusion: Motivated eye donation is a major and effective source of cornea collection in the eye bank under study with "younger" and better quality corneas compared to voluntary donors.

Profile of donors and corneal tissue obtained through hospital cornea retrieval programme in a recently established eye bank of a tertiary care teaching hospital of Eastern India

“…Co-ordination with law-enforcement agencies and the department of forensic medicine in the institution helps speed up formalities in medico-legal cases, in contrast with the Nepal Eye Bank where such obstacles are met with. [ 33 ] In the present EB, there is proper co-ordination with the other EB in the city to provide required tissues and media when asked for. This is also in contrast to that reported in the North East England study where lack of utilization has been reported after corneas were issued, because the patient was unfit, unavailable, or no longer required the transplant.…”

“…The latter utilizes 97% of transplantable tissues collected because of equitable country-wide distribution as well as sending of surplus tissues outside the country. [ 33 ] About 68% (34/50) of utilizable corneas were used for optical purposes including penetrating keratoplasty and triple procedure (cataract surgery with corneal replacement, 15/50). This is comparable to a study from the National Eye Bank in the apex institute of this country where optical corneal replacement was performed in about 60% of cases (106/177).…”

Effect of Donor Age and Corneal Endothelial Cell Density on Non-utilization of Donor Corneal Tissues: A Study From Indian Eye Banks

“…However, we did not compare the percentages of non-utilised corneas corneas from the respective collection pool. Bajracharya et al 6 reported a 16.2% discard rate and that poor tissue quality accounted for 11% in their study; motivated donations constituted 87.7%, and tissues were mainly preserved in Cornisol (85%).…”

“…7 The high rate of utilization of .69% from previous studies has been attributed to several factors, such as a young donor, lesser death-to-preservation time, and a wellestablished HCRP. [4][5][6] Ranjan et al 4 reported septicemia (n = 56, 30%) as the most common cause of non-utilization, followed by poor tissue quality (n = 55, 30%). Patel et al 5 reported biologic contamination followed by abnormal serology as common causes of non-utilization.…”

“…The utilization rate as high as 75% to 83% has also been reported in some countries. [4][5][6] However, pooled data from 12 major eye banks of India reported a lower utilization rate of 50.5% (10,387/20,564). Of these data, causes of non-utilization were available only in 291 eyes.…”