Heather Machin1,2, Gerard Sutton3,4, Paul N Baird2. 1. Lions Eye Donation Service, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. 2. Department of Surgery, Ophthalmology, University of Melbourne, Victoria, Australia. 3. The University of Sydney, Save Sight Institute, Discipline of Ophthalmology, Sydney Medical School, Sydney, Australia; and. 4. The University of Technology Sydney, Graduate School of Health, New South Wales, Australia.
Abstract
PURPOSE: There is a global demand for corneal tissue (CT) for transplantation, with some nations potentially able to export donations to those nations without. Unfortunately, there remains a global paucity of information that explains the process of exportation and importation (transnational activity), supports or defines practice, or informs those seeking to engage. Without knowledge, inclusive of the pros and cons, participating nations and decision makers are unable to make effective and informed decisions. METHODS: Through the example of our own nation, Australia, which may be entering a surplus-to-domestic demand phase and able to export, we conducted qualitative grounded-theory semistructured interviews with sector experts. Our approach ascertained whether Australia should export and under what arrangements. Through saturation and sentiment methods, we capture for the first time, global opinion on CT transnational activity (although primarily exportation), key themes, and finally determine whether Australia should engage. RESULTS: Eighty-four (91%) of 92 participants directly commented on our question "should Australia export corneal tissue?" Of 84, n = 67 (80%) stated yes, n = 17 (20%) indicated mixed opinions. No participant categorically stated that there should be no export. CONCLUSIONS: Eye tissue and eye care experts whom we interviewed, supported the concept of Australia exporting CT; however, they advise several safeguards to protect both import and export nations. Principally, they recommended practice be transparent with donors, nationally coordinated, part of a wider humanitarian program, nonprofit, short term for the importing nations as they move toward self-sufficiency and that Australia must define and confirm domestic need and ensure that demand is met before routine exportation.
PURPOSE: There is a global demand for corneal tissue (CT) for transplantation, with some nations potentially able to export donations to those nations without. Unfortunately, there remains a global paucity of information that explains the process of exportation and importation (transnational activity), supports or defines practice, or informs those seeking to engage. Without knowledge, inclusive of the pros and cons, participating nations and decision makers are unable to make effective and informed decisions. METHODS: Through the example of our own nation, Australia, which may be entering a surplus-to-domestic demand phase and able to export, we conducted qualitative grounded-theory semistructured interviews with sector experts. Our approach ascertained whether Australia should export and under what arrangements. Through saturation and sentiment methods, we capture for the first time, global opinion on CT transnational activity (although primarily exportation), key themes, and finally determine whether Australia should engage. RESULTS: Eighty-four (91%) of 92 participants directly commented on our question "should Australia export corneal tissue?" Of 84, n = 67 (80%) stated yes, n = 17 (20%) indicated mixed opinions. No participant categorically stated that there should be no export. CONCLUSIONS: Eye tissue and eye care experts whom we interviewed, supported the concept of Australia exporting CT; however, they advise several safeguards to protect both import and export nations. Principally, they recommended practice be transparent with donors, nationally coordinated, part of a wider humanitarian program, nonprofit, short term for the importing nations as they move toward self-sufficiency and that Australia must define and confirm domestic need and ensure that demand is met before routine exportation.
Authors: Heather M Machin; Lisa Buckland; Christine Critchley; Steven Wiffen; Gerard Sutton; Paul N Baird Journal: PLoS One Date: 2021-02-19 Impact factor: 3.240