Review of developments in corneal transplantation in the regions of Brazil - Evaluation of corneal transplants in Brazil

Abstract

The aim of this study was to identify inequalities in corneal donation and transplantation among the regions of Brazil. A transversal and retrospective study was specifically conducted using data from the Brazilian Transplant Registry collected by the Brazilian Association of Organ Transplantation between January 2002 and December 2014. The collected data were processed using descriptive statistical methods, and p<0.05 was the rate of rejection of the null hypothesis. From 2002 to 2014, there was an increase in the absolute number of corneal transplants, the annual rate of transplants per million people and the percentage of needed transplants performed in each of the five regions of Brazil. Family refusal and medical contraindication were the most frequent reasons for a lack of corneal donation. Although remarkable progress has been made in the last decade in each of the five Brazilian regions, health professionals’ lack of preparation to approach families with donation requests at the death of a family member appears to be the main obstacle to increasing the number of corneal donations. Thus, the present study suggests the implementation of public policies to make corneal transplants more effective, particularly given that there are considerable disparities in the effectiveness with which regional needs are met and in health professionals’ ability to perform transplants among the Brazilian regions, with higher rates in the South, Southeast and Midwest regions and lower rates in the North and Northeast regions.

Trend of transplants and organ and tissue donations in Brazil: a time series analysis

“…Another important aspect pointed out by the literature when dealing with families is the professional experience, since up to 80% of people consent to the donation when they are approached by experienced and trained professionals. In contrast, there is only 35.5% of agreement when they are inexperienced (21,24) . The role of the nurse is highlighted, as his assistance is based on the particularities of each family, creating bonds of respect and trust, through the dialogical relationship, acting as caregiver, educator and facilitator for donation (28) .…”

“…Research carried out from 2012 to 2014 found that Northeast and Southeast had the largest number of patients waiting for corneal transplantation, with the Southeast meeting near 70% of this demand (24) . The results obtained show that the North and Northeast Regions face difficulties in the corneal procurement and donation processes, which are related to the disruption of programs, low report rate, employee strikes, shortage of trained professionals and poor hospital infrastructure (24) .…”

Epidemiology of corneal transplantation before achieving the Zero Queue

“…This leaded to the adoption of a different approach by these health providers, such as talking about the empathy for the relatives of the possible donor and the possibility of optimizing the quality of life of other patients in order to have an increase in the number of donors and, consequently, in the number of transplants performed. [20] In a study in Ethiopia, transplantation remained a challenge for many patients in low-resource situations. The surgical technique was complicated because of a lack of infrastructure support, including a lack of adequately equipped eye banks and operating rooms, and limited access to trained cornea surgeons and appropriate postoperative follow-up.…”

Perspectives of Decision-Making for Corneal Donation: A Qualitative Research Among Cancer Patients

“…A limitation of this study is that we did not visit family opinions regarding this issue. A previous study showed that the thoughts of family members affect cornea donations (Almeida, Hida, & Kara, 2016). The family usually refused to donate the patient's corneas even when the patient was willing to donate before death (Rabiu, Oshola, & Adebayo, 2016).…”