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A Core-based Risk-analysis for the Evaluation of the Safety of Corneal Donors

1Langer C., 2Fischer U., 1Eichhorst A., 3Wilhelm F., 3Duncker G. I. W., 4Bredehorn T.,
1DSO-Gesellschaft für Gewebetransplantation, Gemeinnützige Körperschaft (Halle/Saale)
2Martin-Luther-Universität, Institut für Medizinische Mikrobiologie (Halle/Saale)
3Martin-Luther-Universität, Klinik und Poliklinik für Augenheilkunde (Halle/Saale)
4Martin-Luther-Universität, Klinik und Poliklinik für Augenheilkunde, Arbeitsbereich für experimentelle Elektroophthalmologie (Halle/Saale)

Purpose: Current methods for organ-culture used in eye-banks have made keratoplasty become a well prepared procedure for patient and physicians. Organ-cultured grafts are transplanted days or weeks after the explantation. This gives much time for a comprehensive risk analysis of the donor. Despite the availability of contraindication lists, several decisions are based on the individual case. It was the aim of this study to provide an aid to decision-making.
Methods: First, known risk-factors for the transmission of the hepatitis B virus were listed. The risk-factors were transferred to specific risks in typical donation situations. Each risk was analysed for the affected group of donors, possible procedures for risk-reduction and the relevance of the risk.
Results: Risk factors were found in the following categories: medical history, social history, laboratory tests and donor screening. Also for donors with an inconspicuous history several risks for the transmission of the hepatitis B virus could be identified (basal risk). For the range between the basal risk and the contraindications regulated in guidelines a score was developed. This score may be an useful aid for the decision on the release of corneal grafts.
Conclusions: Using score systems it is possible to aid clear decisions in multi factor based situations. In the case of corneal banking, scores can be used to aid the release of corneal transplants.

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