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Impressum
Shortage in the face of plenty: Donor situation, cornea allocation and Eurotransplant waiting list.
De By T. M. M. H.
BIS Foundation and Eurotransplant, Leiden
Background: Cornea allocation for transplantation in HLA typed
recipients by BIS is a guideline of the Bundesärztekammer. By successful
international cooperation with different international cornea banks, BIS
offers corneas for patients from different countries. In some countries
there is an absolute shortage of corneas. This causes a situation in which
ophthalmologists can't afford to wait for a well matched transplant. Often,
patients who are indicated for an HLA matched keratoplasty will receive
an unmatched graft. Different studies have shown the beneficial effect
of HLA matching. The challenge for the BIS organisation is to provide
optimal matched corneal grafts with the shortest possible waiting time
for the recipients.
Methods: The aforementioned international cooperation, as well
as the introduction of new tissue typing techniques, brings the goal of
optimal matching and minimal waiting time closer than ever before.
Results: In the first 6 months of 2001 the number of available
HLA typed corneas for transplantation has more than doubled as compared
to the same period of the year 2000. As a result, the waiting list for
HLA-typed recipients has decreased with more than 10%. DNA typing has
resulted in new immunological insights about donorrecipient matching.
For this reason it has been proposed to adapt the international allocation
criteria of BIS, based on scientific consensus. The expectation is that,
as a result of these new allocation criteria, the time on the waiting
lists for HLA typed recipients will be further reduced and the match-grade
will be improved.
Conclusion: Thus, every ophthalmologist can afford to wait for
a typed graft for patients who are indicated for an HLA matched cornea.