Impact of the cornea donor study on acceptance of corneas from older donors

Abstract

Purpose: To evaluate retrospectively whether the findings from the Cornea Donor Study (CDS) led to changes in the transplantation of corneas from older donors.

Methods: Eye banks in United States provided complete data on donor age and placement (domestic or international) for 86,273 corneas from 1998 to 2009. The data were analyzed by 3 periods, preceding CDS (1998-1999), during CDS (2000-2007), and after publication of CDS 5-year results (2008-2009), and separately for corneas placed within versus outside the United States.

Results: For corneal tissues transplanted in the United States, the percentage of donors who were 66 years or older increased from 19% before CDS to 21% during CDS and 25% after CDS (P<0.001). Corresponding median (25th-75th percentile) donor ages were 53 (39-63), 54 (41-64), and 57 (46-66), respectively (P<0.001). The opposite trend was observed for corneas distributed outside the United States, with the percentage of donors 66 years and older decreasing from 56% to 42% to 34%, respectively. Donor age trends over time varied by eye bank.

Conclusions: There was a modest overall increase in the donor age of corneas transplanted in the United States from 1998 to 2009, but the retrospective nature of the study limits our ability to attribute this change to the CDS. The modest increases in the donor age of corneas transplanted is a positive finding, but wider acceptance of older corneal donor tissue should be encouraged based on the 5-year evidence generated by the CDS.

Figures

Figure 1. Donor Age of Corneal Tissues Placed in US and Internationally

Includes data from 15 US eye banks on donor tissues placed in the US (n=110,139, A), and internationally (n=38,379, B) during the period from 1998 to 2009. Corneas used in the CDS were excluded. For 1394 tissues the recipient location is unknown. Black dots indicate mean values; horizontal lines in the boxes, medians; the bottom and top of the boxes, the 25th and 75th percentiles, respectively; and the horizontal lines outside of the boxes, the range of donor age. Horizontal line across the graph corresponds to donor age of 66 years. The percentage figure above each box is the percentage of donors 66 or older.