• Transplant Suitability of Corneal Tissue From Donors With Diabetes

    By Lynda Seminara and selected by Neil M. Bressler, MD, and Deputy Editors

    Journal Highlights

    JAMA Ophthalmology, February 2017

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    As the prevalence of diabetes contin­ues to grow, so does the pool of donor tissue from individuals with the disease. Margo et al. reviewed a large data set of donated eyes (including approximately 31% from donors with type 1 or type 2 diabetes) and found no correlation between the presence or severity of diabetes and the suitability of the corneal tissue for transplantation.

    Donor information was obtained from the SightLife Eye Bank for the 3-year study period (2012-2015). Data included endothelial cell count, lens status, medical/surgical history, transplant suitability, and time from death until refrigeration and preserva­tion of the cornea. The main outcome measures were endothelial cell density, suitability for transplantation based on tissue analysis, and technician-induced endothelial damage. The researchers stratified donors in categories of severe and nonsevere diabetes to assess the effect, if any, of disease severity.

    Among 14,532 donors (mean age, 58.6 years), the mean endothelial cell count was 2,732 cells/mm2. Type 1 or 2 diabetes was listed in the medical his­tory for 8,552 (30.6%) of 27,948 donor eyes; 5,242 eyes (18.8%) were from patients with severe diabetes. After ad­justing for factors including sex, phakia versus pseudophakia, and time from death to tissue refrigeration/preserva­tion, no correlation was found between the presence of diabetes (adjusted odds ratio [OR], 0.79; p = .28) or severe dia­betes (adjusted OR, 0.86; p = .54) and suitability for corneal transplantation.

    Contrary to findings from other studies, the endothelial cell counts of donors with diabetes (regardless of disease severity) were similar to those of the overall donor population. Tech­nician-induced endothelial damage occurred in 59 corneas (0.2%) but was not associated with diabetes.

    The authors concluded that dia­betes, which is increasingly common among cornea donors, is not associated with lower endothelial cell counts or poor suitability for transplantation. Longitudinal studies are warranted to determine the long-term outcomes of transplanting corneal tissue from donors with diabetes.

    The original article can be found here.