Transplantation of ocular tissue from a donor with sporadic Creutzfeldt-Jakob disease

TitleTransplantation of ocular tissue from a donor with sporadic Creutzfeldt-Jakob disease
Publication TypeJournal Article
Year of Publication2006
AuthorsTullo AB, Buckley RJ, Kelly T, Head MW, Bennett P, Armitage WJ, Ironside JW
JournalClin Experiment Ophthalmol
Pagination645 - 9
Date PublishedSep-Oct
ISSN1442-6404 (Print) 1442-6404 (Linking)
Accession Number16970756
Keywords*Corneal Transplantation, *Tissue Donors, Adult, Aged, 80 and over, Cornea / metabolism, Creutzfeldt-Jakob Syndrome / *complications / transmission, Disease Transmission, Infectious, Eye Banks, Female, Fuchs' Endothelial Dystrophy / surgery, Humans, Immunohistochemistry, Keratoconus / surgery, Male, Middle Aged, Prions / metabolism, Reconstructive Surgical Procedures, Risk Factors, Sclera / metabolism / *transplantation

BACKGROUND: One definite, one probable and several possible transmissions of sporadic Creutzfeldt-Jakob disease (sCJD) have followed corneal transplantation. We report an incident in the UK in 1997 in which both corneas and scleras from a donor, subsequently confirmed to have had sCJD, were transplanted. The final clinical outcome for two surviving recipients is still not yet known. CASE REPORT: In 1997, a 56-year-old woman died from biopsy-proven carcinoma of the bronchus. Both eyes were donated for transplantation. Shortly before she died, she had developed neurological symptoms thought to be due to brain metastases. However, the final result of a neurological post-mortem examination revealed evidence of sCJD. By this time the corneas had been transplanted, one 3 months previously into a 40-year-old man for keratoconus and the other 4 months previously into an 85-year-old woman for Fuchs' dystrophy. In addition, both scleras had been transplanted into a 36-year-old man undergoing oculoplastic reconstructive surgery. The surgeons and patients were informed and removal of tissue was advised but undertaken in only two of the patients. Immunohistochemistry failed to demonstrate the presence of the abnormal form of the prion protein in explanted tissue. CONCLUSIONS: Eight years after the event, two patients remain free of symptoms suggestive of iatrogenic CJD ( The third having died aged 92 years, some 7 years after surgery, showing signs of dementia not considered indicative of iatrogenic CJD. Nevertheless this adverse incident attracted substantial publicity. Coupled with continuing concerns in the UK about person-to-person transmission of variant CJD, this has lead to a number of important consequences in donor eye retrieval, ocular tissue banking and transplantation.

URLinternal-pdf://Tullo - CJD-0624885505/Tullo - CJD.pdf
Notify Library Reference ID1562

Related Incidents