PubMed · 15413688
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J V M ROSS. 1950. Keratoconus posticus generalis.. https://doi.org/10.1016/0002-9394(50)90210-8
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BACKGROUND: During organ culture, corneas swell and have to be de-swollen prior to transplantation using a medium. Both swelling and de-swelling lead to increased endothelial cell loss. Furthermore, dextran, the standard de-swelling substance, is toxic and deposited in the cornea. Whether HES is suitable as a continuous supplement for organ culture and keeps the corneas thin was investigated in this study. METHODS: Forty-five human corneas were stored in MEM plus 7.5% HES 130 for 7, 15, 21, and 28 days. Endothelial cell count was determined before and after organ culture. After storage the water content and amount of adenosine phosphates were measured. RESULTS: Water content was 82.29% after 7 days, 82.98% after 15 days, 81.15% after 21 days, and 83.21% after 28 days. The endothelial cell count decreased by 1.20% after 7 days, 0.60% after 15 days, 4.29% after 21 days, and 6.89% after 28 days. ATP was 0.159 micromol/g dry weight after 28 days of organ culture. CONCLUSION: The water content of corneas stored in HES-containing medium remained constant even after 21 days of organ culture. Endothelial cell loss was less than in comparable studies using a standard medium containing 10% FCS; however, ATP concentrations were worse. HES 130 keeps the corneas thin and can be used as a continuous supplement. It facilitates the handling of corneas during organ culture, making dehydration before transplantation unnecessary, and thus also reduces potential stress factors for the cornea.
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PURPOSE: The combination of a shortage of cornea grafts in France and a national average contamination rate of 9% to 10%, has led us to search for the origins of this contamination. The objective of our study was to reduce the number of unusable grafts resulting from contamination of corneas in organ culture. METHODS: An external audit was carried out by an independent pharmacist on the removal conditions and treatment procedures for corneas. An environmental study was carried out, consisting of microbiological sampling of the corneas of donors who just died (<24 hours) as well as water and air samples in the premises used for removal. The Cornea Bank's procedures were submitted to a microbiological risk analysis using the "failure mode effects and criticity analysis" (FMECA) method. RESULTS: The critical contamination periods were found to be before removal, during mortuary washing and during decontamination of the conjunctival cul-de-sac at the removal stage. The corrective measures taken have reduced contamination rates by half in 1 year. CONCLUSION: Highlighting the sources of contamination has led to the implementation of effective targeted and low-cost measures that have allowed us to reduce significantly the number of cornea graft losses as a result of bacterial and fungal contamination.