Organ-cultured corneal grafts from septic donors: a retrospective study

PURPOSE: To evaluate the quality of corneal grafts from donors, who have died from septic multi-organ failure and who are called septic donors in the following. METHODS: One hundred and eighty-two corneal grafts from septic donors were stored in organ culture for 10-14 days. Graft evaluation was performed according to the criteria of the European Eye Bank Association. Only donor corneas with cell density values above 2000 cells/mm(2) were transplanted. Ninety-one patients who received these transplanted corneas were examined retrospectively with special emphasis on endophthalmitis, graft failure and incidence of immune reactions. RESULTS: Ninety-one of 182 donor corneas (50%) from septic donors were discarded mainly due to endothelial damage (61; 67%). Only seven (8%) were discarded due to medium contamination. In contrast, 452 of 1261 donor corneas (36%) from non-septic donors during the same period were discarded, again mainly due to endothelial damage (264; 58%). In this group, 48 donor corneas (11%) were discarded due to medium contamination. No patient who had received a graft from a septic donor has experienced endophthalmitis. The rate of immune reactions and graft failure was in the same range when compared to a larger group who received grafts from non-septic donors. CONCLUSION: Our data reveal no contraindication against the use of corneal grafts derived from septic donors, critical graft assessment in organ culture provided.