HERPES-SIMPLEX-VIRUS-INFECTION OF DONOR CORNEAE DURING ORGAN CULTURE

97th DOG Annual Meeting 1999

K97
HERPES-SIMPLEX-VIRUS-INFECTION OF DONOR CORNEAE DURING ORGAN CULTURE - FREQUENCY AND CONSEQUENCES

U. Sengler¹, T. Reinhard¹, O. Adams², C. Krempe²

Background: According to PCR studies 2-20% of organ culture donor corneae harvest Herpes simplex virus (HSV)-DNA, but there are only four cases with a proven infection of a corneoscleral disc published so far. Recently we could observe dendritiforme epithelial alterations and subsequent complete endothelial necrosis in a donor cornea. HSV type I was isolated in a virus culture out of the medium. To evaluate the frequency of HSV infection as a cause of endothelial necrosis in organ culture we tested the media of donor corneae with severe or total endothelial necrosis between 1995 and 1998.

Methods: As a negative control group we screened the media of 30 transplanted corneae using PCR for HSV type 1. Then we examined the frozen media of 60 corneoscleral discs with severe or total endothelial necrosis with PCR.

Results: In the control group we had only negative PCR results, in contrast to the corneae with severe or total endothelial necrosis where HSV type I was detected with PCR in seven media of five patients (10.6%). Virus culture was positive in four of these seven media. All five donors had a history of multiple medical problems.

Conclusions: 1. HSV infection is a possible but neglected cause for endothelial necrosis in organ culture corneae. 2. Virus replication in the donor cornea at the time of excision is a premise for this. 3. Donors with a history of multiple medical problems are at a greater risk for such a replication of HSV. 4. We consider the risk of transplanting" active Herpes simplex virus to be very small if critical corneae assessment before keratoplasty is granted.

Eye Hospital¹ and Institute of Med. Microbiology and Virology², Heinrich-Heine-University, Moorenstr. 5, D-40225 Duesseldorf, Germany

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