{
  "abstract": "Purpose Corneal blindness is a leading cause of blindness worldwide. Cornea distribution for transplant is uneven with adequate supply in some countries, while large gaps are evident in others. A major challenge to bridging the supply gap includes small donor pools, with a projected worsening over time. Approaches to increasing cornea tissue availability for transplantation include expanding donor pools through advocacy and modifying parameters like age and Death-to-Preservation (DtP) time to ensure the wish of potential donors to give the gift of sight is met. This study aimed to identify the changes in cornea tissue availability with modification of recovery parameters.Method Donor eligibility parameters for cornea recovery modified were Death-to-Preservation (DtP) time and donor age. DtP was reviewed upwards by 6 hours from ≤18 hours to ≤24 hours to increase tissue availability from existing consented donors, and the upper limit for donor age eligibility was increased by 5 years from 75 years to 80 years for donor pool expansion. Of note, all donors age > 70 years old with history of cataract surgery were excluded at recovery. A 26-month retrospective review of operational data was done to determine cornea tissue outcomes and the changes resulting from criteria modifications. Endothelial cell density was evaluated to assess quality. Univariate analysis was done using Microsoft Excel and reported as frequencies and percentages.Results Total cornea tissues recovered were 4637 over the 26 months. 3384 (73.0%) of the corneas recovered were transplanted, 771 (16.6%) were placed for research, training and education (RTE) and 482 (10.4%) were discarded for varied reasons. Among the 3384 corneal tissues transplanted, 2416 (71.4%) met the previous criteria (DtP ≤18 Hours; donor age 2 -75 years) while an additional 968 (28.6%) corneas were transplanted due to the changes to the donor eligibility criteria (DtP ≤24 Hours; donor age 2 – 80 years). Endothelial cell densities were similar with about a third of transplanted tissue exceeding 3000 cells/mm2, regardless of criteria.Discussion Operational changes to recovery parameters resulted in an increase in corneal tissue availability for transplant without compromise in corneal tissue quality. Corneal tissue procured from older donors with increased death-to-preservation time showed similar quality outcomes. Other studies also suggest similar rates of survival among corneal tissue grafts from older versus younger donors and grafts with longer death-to-preservation time. Existing gaps in global cornea tissue availability for transplant can be met through innovative approaches to donor pool expansion. Further review of donor eligibility criteria may still hold the potential to increase cornea tissue availability for transplant, to meet global demand.",
  "authors": [
    {
      "affiliations": [
        "Lions Eye Bank of Wisconsin, Madison, USA"
      ],
      "name": "Andreea Bauknecht"
    },
    {
      "affiliations": [
        "Lions Eye Bank of Wisconsin, Madison, USA"
      ],
      "name": "Tolulope Oyedun"
    },
    {
      "affiliations": [
        "Triteez Health Solutions LLC, Sun Prairie, USA"
      ],
      "name": "Olaitan Oyedun"
    }
  ],
  "title": "1.3. Impact of donor criteria modification on cornea tissue availability for transplant",
  "uid": "8a4200d8-09b5-5e14-8407-52a4912800d9"
}