Comparison of utilization rate and graft outcomes of corneas from cadaveric donors (CDs) versus multiorgan donors (MDs).

Purpose: The purpose is to compare the utilization rate and corneal graft outcomes from multiorgan donors (MDs) versus those from cadaveric donors (CDs).

Methods: In this ambispective and observational study, 36 corneas obtained from MDs and 72 corneas from their age-matched and sex-matched voluntary donors under the Hospital Cornea Retrieval Program (HCRP) from an eye bank were assessed clinically using slit lamp and under a specular microscope for their suitability for utilization. The percent utilization for keratoplasties was noted and compared between the two donor sources as the primary outcome. The transplanted corneas were followed up for 18 months for the assessment of graft survival and other outcome parameters.

Results: The utilization rate of corneas obtained from MDs (80.6%) was significantly higher than that of corneas obtained from CDs (68.1%). The mean endothelial cell density (ECD) was significantly higher in corneas from MD as compared to those from CD (P = 0.037) at 18 months. The Kaplan-Meier survival analysis revealed a cumulative graft failure rate over 1.5 years as 10.3% for corneas obtained from MD and 16.3% for corneas obtained from CD. The microbiological analysis of the corneoscleral rim sent intraoperatively revealed three culture-positive specimens, two from CD, and one from MD.

Conclusion: The donor source was a significant factor in determining the suitability of corneas for keratoplasty. Death preservation interval, cause of death, ECD, and processing had a modest influence on tissue suitability or quality. This data may help eye banks formulate policies that can maximize the procurement of corneas from MDs under HCRP.