Corneas collected post-mortem are vulnerable to microbial contamination, thus necessitating decontamination before storage, aseptic techniques throughout the processing stages, and antimicrobial preservation in the storage media. Nevertheless, the presence of microorganisms leads to the rejection of corneas. Following cardiac arrest, corneas are ideally collected within 24 hours, according to professional guidelines, but may be procured up to 48 hours later. Our mission was to evaluate the contamination risk in relation to the period following death and the type of microbes isolated.
0.5% povidone-iodine and tobramycin was used to decontaminate corneas before procurement. The treated corneas were placed in organ culture medium and microbiologically tested after a storage period of four to seven days. Ten milliliters of cornea preservation medium were introduced into two blood bottles (aerobic, anaerobic/fungi, Biomerieux), which were subsequently incubated for seven days. A retrospective analysis of microbiology testing results spanning the four-year period from 2016 to 2020 was conducted. Post-mortem corneas were sorted into four groups dependent on the post-mortem interval: group A (post-mortem interval under 8 hours), group B (post-mortem interval from 8 to 16 hours), group C (post-mortem interval from 16 to 24 hours), and group D (post-mortem interval over 24 hours). All four groups' isolated microorganisms were evaluated concerning both the rate and range of contamination.
Organ culture was employed to store 1426 corneas obtained in 2019, which were subsequently subjected to microbiological testing. A statistically significant 46% (65/1426) of the corneas tested displayed contamination. Across all samples, 28 bacterial and fungal species were identified. In the Saccharomycetaceae fungi of group B, bacteria from the Moraxellaceae, Staphylococcaceae, Morganellaceae, and Enterococcaceae families were predominantly isolated, accounting for 781% of the total. The microbial profile of group C frequently included the Enterococcaceae and Moraxellaceae bacterial families and the Saccharomycetaceae fungal family, making up 70.3% of the total isolates. Group D bacteria, classified within the Enterobacteriaceae family, were fully isolated (100%).
Through the application of organ culture techniques, microbiological contamination in corneas can be both identified and removed. Our research demonstrates a higher rate of microbial contamination in corneas with extended post-mortem times, implicating a relationship between these contaminations and post-mortem donor alterations, rather than infections present prior to death. For the preservation of the donor cornea's superior quality and safety, disinfection procedures and a concise post-mortem interval are crucial.
Organ culture procedures permit the identification and discarding of corneas affected by microbial contamination. A statistically significant correlation was observed between prolonged post-mortem intervals and a higher rate of microbial contamination in corneas. This implies that such contamination is more likely due to post-mortem donor changes than preceding infections. For maximum quality and safety of the donor cornea, disinfection of the cornea and minimizing the duration of the post-mortem interval are essential actions.
The Liverpool Research Eye Bank (LREB) focuses on the collection and preservation of ocular tissue specimens, which are then used in research endeavors investigating ophthalmic conditions and possible therapies. In cooperation with the Liverpool Eye Donation Centre (LEDC), our team gathers whole eyes from the deceased. The LEDC identifies potential donors and approaches their next-of-kin for consent, representing the LREB; nonetheless, transplant compatibility, time constraints, medical limitations, and other issues can curtail the donor pool. The twenty-one-month period encompassing the COVID-19 outbreak has significantly discouraged donation. The study's purpose was to measure the impact that the COVID-19 global health crisis exerted on donations to the LREB.
Between January 2020 and October 2021, the LEDC meticulously assembled a database containing the results of decedent screens conducted at the site of The Royal Liverpool University Hospital Trust. From the provided data, the viability of each deceased person for transplantation, research, or rejection in both areas was assessed, including the specific number of deceased individuals ruled out due to concurrent COVID-19 infection. The number of families initially approached for research donations, along with the subsequent number who granted consent and the resulting number of tissues collected, were all included in the data.
During the years 2020 and 2021, the LREB's collection of tissues from decedents with COVID-19 listed on their death certificates was nil. The period encompassing October 2020 to February 2021 was marked by a considerable rise in the number of unsuitable donors for transplantation or research, primarily due to the spread of COVID-19. The reduced approaches were made towards the next of kin. Despite the COVID-19 pandemic, the donation rate remained seemingly unaffected. Donor consent figures, oscillating between 0 and 4 per month over 21 months, exhibited no relationship with the peak periods of COVID-19 fatalities.
Donor numbers remain largely independent of COVID-19 cases, suggesting other determinants are at play in donation behavior. Increased understanding of donation avenues for research purposes could stimulate higher donation rates. Producing instructional materials and coordinating engagement events will greatly assist in reaching this goal.
COVID-19 case counts show no connection to donor numbers, suggesting that factors beyond the pandemic influence donation rates. Educating the public about the research donation option could spur an increase in donations. tumour biomarkers Aiding in this endeavor will be the development of informational resources and the planning of outreach activities.
In the face of SARS-CoV-2, the coronavirus, the world encounters novel challenges. The ongoing crisis in several nations strained Germany's healthcare system, first by demanding resources for COVID-19 patients and, second, by interrupting scheduled, non-emergency surgeries. Risque infectieux This development had an undeniable impact on the realm of tissue donation and transplantation activities. The initial closure measures in Germany saw a considerable decrease, almost 25%, in corneal donation and transplant numbers within the DGFG network between March and April 2020. Following a period of activity freedom during the summer, October saw restrictions reimposed due to the rising infection figures. POMHEX manufacturer Later in 2021, a parallel trend developed. The already stringent evaluation of potential tissue donors was intensified, conforming to the Paul-Ehrlich-Institute's standards. This important measure, however, triggered a substantial increase in donations being discontinued, due to medical contraindications, rising from 44% in 2019 to 52% in 2020, and ultimately reaching 55% in 2021 (Status November 2021). The 2019 results for donation and transplantation were not only exceeded but also allowed DGFG to maintain a consistently stable level of patient care in Germany, matching the performance of many other European countries. This positive outcome is attributable, in part, to a notable increase in consent rates, reaching 41% in 2020 and 42% in 2021, a consequence of heightened public sensitivity towards health issues during the pandemic. 2021 saw a return to stability, but the number of unfulfilled donations, linked to COVID-19 detection in the deceased, continued to increase proportionally with the resurgence of infection waves. The prevalence of COVID-19 infections varying regionally necessitates a responsive approach to donation and processing procedures. This involves adjusting to local conditions while maintaining essential operations in those regions where transplants are crucial.
To facilitate transplants throughout the UK, surgeons are supported by the NHS Blood and Transplant Tissue and Eye Services (TES), a multi-tissue bank. TES serves scientists, clinicians, and tissue banks with access to a selection of non-clinical tissues for research, training, and educational use. Of the non-clinical tissues delivered, a substantial portion comprises ocular specimens—whole eyes, corneas, conjunctiva, lenses, and the posterior sections that remain following corneal removal. The TES Research Tissue Bank (RTB), a component of the TES Tissue Bank in Speke, Liverpool, is supported by two full-time staff members. Across the United Kingdom, Tissue and Organ Donation teams procure non-clinical tissue. The RTB has very close relations with the David Lucas Eye Bank in Liverpool and the Filton Eye Bank in Bristol, both part of the TES network. TES National Referral Centre Nurses primarily obtain informed consent for non-clinical ocular tissues.
Two different routes transport tissue to the RTB. The first path is marked by tissue directly consented and obtained for non-clinical purposes; the second path includes tissue that becomes available after evaluation for clinical viability. The second pathway is the primary source of eye bank tissue received by the RTB. A significant number, exceeding one thousand, of non-clinical ocular tissue samples were provided by the RTB in 2021. Sixty-four percent of the tissue was allocated to research, encompassing areas such as glaucoma, COVID-19, pediatric studies, and transplantation research. Clinical training projects accounted for 31% of the tissue, emphasizing DMEK and DSAEK procedures, especially in the post-pandemic era, including training for new eye bank staff. The remaining 5% was reserved for in-house and validation purposes. A notable finding revealed corneas remain usable for educational purposes even six months following their removal from the eye.
A partial cost-recovery system is employed by the RTB, which became self-sufficient in 2021. Non-clinical tissue provision is vital to advancing patient care, resulting in multiple peer-reviewed publications.
The RTB, operating under a partial cost-recovery model, attained self-sufficiency in 2021.