• Is It Time to Reconsider Cornea Donation Guidelines?

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, November 2020

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    Concern about the risk of HIV trans­mission via corneal transplantation prompted North American authorities to ban cornea donation from men who had sex with other men (MSM) during the preceding 12 months (Canada) or five years (the United States). Puente et al. assessed the consequences of these rules and found that in 2018 alone, up to 3,217 corneas could have been added to the transplantation supply if the ban had not existed.

    For this study, the investigators con­ducted a telephone survey of the 65 eye banks in North America to estimate the number of corneas disqualified due to the MSM restrictions. For banks whose initial screening process was handled by a partner organ-procurement facility, the authors contacted the partner firm to obtain the data. Eye banks that did not log MSM-related disqualifications were excluded.

    In addition, the authors obtained a separate estimate by reviewing and combining published population-based data on sexual behavior and orientation for the two countries.

    Of the 54 (83%) eye banks that responded, 24 maintained the relevant records. Among these 24 banks, 360 referrals were denied in 2018 because of MSM status, which would equate to 720 corneas. The same 24 eye banks accounted for 46.2% of cornea dona­tions in the United States and Canada in 2018. Assuming that those banks also represented 46.2% of total North American MSM donor deferrals, the overall number of corneas denied on this basis in 2018 would be 1,558. The separate estimate of published demographics indicated that up to 3,217 corneas intended for donation may have been disqualified in 2018 by the MSM policies.

    In light of modern virologic testing that is reliable within days of HIV exposure, coupled with the ongoing need for cornea tissue, the authors urge reevaluation of MSM-related policies. (Also see related commentary by Alan Sugar, MD, and Woodford S. Van Meter, MD, in the same issue.)

    The original article can be found here.