Donor Age May Not Affect Corneal Transplants

December 04, 2013

By Andrew M. Seaman

NEW YORK (Reuters Health) Dec 04 - Despite concerns that corneas from older donors might not last, a new U.S. government study finds 10-year graft survival is not significantly affected by donor age.

The findings may lead to more donor corneas becoming available both for transplants in the U.S. and for export to other countries, according to the study's lead author.

"By expanding the range of donor tissue, we'll be able to provide more donor tissue for the vast majority of the world," said Dr. Mark Mannis, who is the chair of ophthalmology and vision science at the University of California, Davis.

"Corneal blindness worldwide far outstrips the availability of corneal transplant tissue," he added.

There were about 46,000 corneal transplants performed in the U.S. in 2012, Mannis and his colleagues wrote online November 15 in the journal Ophthalmology. Cornea donors younger than 31 made up less than 10% of the donor pool that year, the researchers note in their report.

Previously, Mannis told Reuters Health, some surgeons would only accept corneal tissue from donors younger than 65, or in some cases, 50.

His group's study involved 1,090 people, ages 40 to 80, who had cornea transplants for endothelial cell etiologies at 80 U.S. medical centers.

In a 2008 study of that cohort, the five-year success rate was 86% regardless of donor age. Corneas from older donors had more cell loss, however, which was tied to a higher likelihood that the transplant would fail.

For the new study, the researchers continued to track 663 of their patients for another five years.

They found that success rates were similar whether the cornea donors were aged 12 to 65, or 66 to 75. Between 71% and 77% of corneas were still viable 10 years later.

When the study team looked at transplant success by narrower donor age groups, however, they did find some differences.

For example, the success rate after 10 years increased to 96% for corneas donated by people between ages 12 and 33 years old, and fell to about 62% when donors were 72 to 75 years old.

But the success rate of donations from people between ages 34 and 71 was consistently about 75%.

Mannis said the results will help reassure corneal tissue recipients they're getting good tissue, encourage surgeons to use tissue from older donors and increase the number donors.

He cautioned, however, that the results pertain to people with endothelial disorders of moderate severity.

"It's not entirely generalizable to people with all kinds of corneal disease," he said.

In a separate analysis, the researchers confirmed that corneas from younger donors lose fewer cells after transplantation, though they still can't say whether a certain amount of cell loss can predict a transplant failure.

Mannis said the study is completed but analysis of the data is continuing.

"We're going to look at this data and see what other things we can learn," he said.

SOURCES: http://bit.ly/1il615S and http://bit.ly/1il615S

Ophthalmology 2013.

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