Cornea Protocol
EYE DONOR SUITABILITY CRITERIA
- General Organ Donor Criteria, except that non-haematological neoplasia or advanced donor age are not necessarily exclusion criteria
- No known corneal trauma or disease. Other eye disease or suregery may be acceptable
- No CNS degenerative disease or known risk factors for CJD.
- Additional exclusion criteria at the discretion of individual Eye Banks.
A full list of suitability criteria is available in the Eye Bank Association of Australia and New Zealand Medical and Quality
Standards for Eye Donation and Eye Tissue Banking
REQUIRED INFORMATION FOR ALLOCATION
- The sources and forms for collection of medical history are the responsibility of individual Eye Banks. However, where eye donation is to occur as part of a multi-organ donation the standard national protocol forms will be used.
- Cause and time of death
- Method and time of corneal preservation
- Any history of eye surgery to enable judgement on appropriate allocation and suitability for a particular type of transplant procedure
- Laboratory tests:
- General organ donor criteria for HIV, Hep BsAg, Hep C, (CMV and Human Chorionic Gonadotrophin Hormone are not required,) slit lamp examination and specular microscopy are routine. Microbiological assessment may also be performed.
- General organ donor criteria for HIV, Hep BsAg, Hep C, (CMV and Human Chorionic Gonadotrophin Hormone are not required,) slit lamp examination and specular microscopy are routine. Microbiological assessment may also be performed.
- ABO, HLA and crossmatch information generally not required.
- Post-mortem examination is not required for donation or allocation of corneas.
RECIPIENT SUITABILITY CRITERIA
- Actual or threatened corneal perforation
- Corneal opacity/oedema or poor vision resulting from corneal pathology
- Chronic pain resulting from corneal pathology
Recognised Corneal Transplant Units and Eye banks (members of EBAANZ)
All ophthalmologists registered with the Royal Australian College of Ophthalmologists are eligible to perform corneal transplantation in authorised hospitals and day care facilities.
| NSW & ACT | - |
Lions Eye Bank of New South Wales |
| VIC & TAS | - |
Lions Corneal Donation Service |
| QLD | - |
Queensland Eye Bank |
| SA & NT | - |
Eye Bank of South Australia |
| WA | - |
Lions Eye Bank of Western Australia |
| NZ | - |
New Zealand National Eye Bank |
EYE RETRIEVAL MECHANISMS
The Eye Bank is usually responsible for arranging consent and surgical donation according to the local state Transplantation Act, and for arranging or performing necessary investigations, corneal preservation and safe distribution. In those States without an Eye Bank an individual ophthalmic
surgeon may sometimes fulfil some of these responsibilities in association with an Eye Bank. Referral of cases as early as possible will facilitate donation. As a benchmark corneas should be retrieved within 12 -24 hours of donor death (depending on the type of cornea preservation used). It is generally recommended that retrieval occur as soon as practicable after circulatory death.
CORNEA ALLOCATION AND DISTRIBUTION
The EBAANZ service agreement between all member Eye Banks provides the terms upon which corneas are distributed between Eye Banks (and thus across the Nation).
Routinely, corneas are allocated and distributed within the State of donation. However, urgent cases take priority where the cornea may be transferred interstate by specific arrangement between Eye Banks, or an Eye Bank and a particular ophthalmologist.
Individual Patient Allocation
Urgent cases
Actual or threatened corneal perforation.
Routine cases
Elective (scheduled) surgery is planned to suit the medical need and convenience of the patient and the surgeon. Factors such as the availability of surgeon and operating facilities, and the condition of the patient will determine actual operating dates. Within this framework some priority is normally given to patients who have been waiting longest.
To view a copy of the EBAANZ Medical and Quality Standards for Eye Donation and Eye Tissue Banking Edition2: April 2009 go to www.ebaanz.org and click on 'Standards'
Date of protocol - August 2002; Date Revised - March 2009/May 2009