Outcome of Human Donor Corneas Stored for More Than 4 Weeks

Purpose:Organ culture is the most common method for preservation of human donor corneas within Europe, and the maximum accepted storage period is typically set to 4 weeks. However, little is known about the fate of prolonged (4+ wks) organ culture storage of donor corneas. The aim of this study was to evaluate the clinical outcomes of corneal grafts preserved from 4 to 7 weeks compared with corneal grafts preserved up to 4 weeks in organ culture medium.Methods:A registry study was performed, identifying 1252 corneal transplantations [Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PKP)] between February 2008 and November 2015 at Aarhus University Hospital, Denmark. Data were extracted from The Danish Cornea Bank Registry and The Swedish Cornea Registry, which also includes Danish patients. The outcomes evaluated, 2 years after transplantation, were graft function, rebubbling rates in DSAEK surgeries, rejection rates, and endothelial cell density (ECD).Results:A total of 808 donor corneas were stored for 29 days, with a mean preservation time being 20 6 days (mean +/- SD, range: 6-29 days). A total of 444 donor corneas were stored for >29 days, with a mean preservation time being 38 +/- 7 days (mean +/- SD, range: 30-72 days). In both DSAEK (n = 835) and PKP (n = 417), no statistically significant difference was observed in the frequency of graft failure (DSAEK, P = 0.9 and PKP, P = 0.74), rebubbling rates (DSAEK P = 0.07), rejection rates (DSAEK, P = 0.08 and PKP, P = 0.95), or ECD (DSAEK, P = 0.56 and PKP, P = 0.44) between donor corneas cultured for 29 days and donor corneas cultured for >29 days.Conclusions:Corneas stored in organ culture for more than 4 weeks are equally suitable for DSAEK and PKP transplantation as corneas stored in organ culture for up to 4 weeks.