Céline Trigaux1, Sabine Salla2, Jan Schroeter3, Theofilos Tourtas4, Henning Thomasen5, Philip Maier6, Olaf J C Hellwinkel7, Ilka Wittmershaus8, Patrick R Merz9, Berthold Seitz10, Bernhard Nölle11, Norbert Schrage12, Sigrid Roters13, Melissa Apel14, Andrea Gareiss-Lok15, Constantin E Uhlig16, Sebastian Thaler17, Florian Raber18, Daniel Kampik19, Gerd Geerling1, Johannes Menzel-Severing1. 1. Department of Ophthalmology, University of Düsseldorf, Düsseldorf, Germany. 2. Department of Ophthalmology, RWTH University Aachen, Aachen, Germany. 3. Institute of Transfusion Medicine, University Tissue Bank, Charité - Universitätsmedizin Berlin, Berlin, Germany. 4. Department of Ophthalmology, University of Erlangen-Nuremberg, Erlangen-Nuremberg, Germany. 5. Department of Ophthalmology, University of Essen, Essen, Germany. 6. Department of Ophthalmology, University of Freiburg, Freiburg, Germany. 7. Department of Ophthalmology, University of Hamburg, Hamburg, Germany. 8. Department of eye banking, Deutsche Gesellschaft Für Gewebetransplantation, Hannover, Germany. 9. Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany. 10. Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg, Saar, Germany. 11. Department of Ophthalmology, University of Kiel, Kiel, Germany. 12. Department of Ophthalmology, Städt. Kliniken Köln, Cologne, Germany. 13. Department of Ophthalmology, University of Cologne, Cologne, Germany. 14. Department of Ophthalmology, University of Mainz, Mainz, Germany. 15. Hornhautbank München gGmbH, Munich, Germany. 16. Department of Ophthalmology, University of Münster, Münster, Germany. 17. Department of Ophthalmology, University of Tübingen, Tübingen, Germany. 18. Department of Ophthalmology, University of Ulm, Ulm, Germany. 19. Department of Ophthalmology, University of Würzburg, Würzburg, Germany.
Abstract
INTRODUCTION: Since the beginning of the COVID-19 pandemic there has been some debate regarding the risk of transmission through tissue transplantation and tissue banking processes. AIM OF THE STUDY: To analyze the changes that SARS-CoV-2 has caused regarding the harvesting of corneal donor tissue and eye bank activities in Germany. METHODS: A questionnaire was provided to 26 eye banks in Germany, consisting of questions about adaptations made in the screening of potential donors and the harvesting of corneal tissue following the pandemic spread of SARS-CoV-2. RESULTS: Eighteen eye banks actively reduced recruitment of donors and two banks ceased all activity. Additional diagnostic screening was performed in eight banks, using conjunctival swabs and/or nasopharyngeal swabs. In six eye banks, additional protective measures, such as FFP2 masks and/or facial shields, were implemented. Overall, a mean reduction in the number of obtained donor tissues of 17% was observed. DISCUSSION: Conjunctival and/or nasopharyngeal swabs of donors have been implemented by a minority. Reasons for not performing additional tests may be moderate sensitivity and lack of validation for postmortem use of RT-PCR testing. Also, the hazard of SARS-CoV-2 entering the corneal donor pool with subsequent transmission might be perceived as theoretical. Face shields provide a sufficient barrier against splash and splatter contamination but may be insufficient against aerosols. Additional face masks would provide support against aerosols, but it remains debatable if corneal harvesting can be considered an aerosol-producing procedure. In the future we expect to see changes in current guidelines because of a surge in scientific activities to improve our understanding of the risks involved with cornea donation in the COVID-19 pandemic, and because current practice may reduce the availability of donor corneas due to new exclusion criteria while the demand remains unchanged.
INTRODUCTION: Since the beginning of the COVID-19 pandemic there has been some debate regarding the risk of transmission through tissue transplantation and tissue banking processes. AIM OF THE STUDY: To analyze the changes that SARS-CoV-2 has caused regarding the harvesting of corneal donor tissue and eye bank activities in Germany. METHODS: A questionnaire was provided to 26 eye banks in Germany, consisting of questions about adaptations made in the screening of potential donors and the harvesting of corneal tissue following the pandemic spread of SARS-CoV-2. RESULTS: Eighteen eye banks actively reduced recruitment of donors and two banks ceased all activity. Additional diagnostic screening was performed in eight banks, using conjunctival swabs and/or nasopharyngeal swabs. In six eye banks, additional protective measures, such as FFP2 masks and/or facial shields, were implemented. Overall, a mean reduction in the number of obtained donor tissues of 17% was observed. DISCUSSION: Conjunctival and/or nasopharyngeal swabs of donors have been implemented by a minority. Reasons for not performing additional tests may be moderate sensitivity and lack of validation for postmortem use of RT-PCR testing. Also, the hazard of SARS-CoV-2 entering the corneal donor pool with subsequent transmission might be perceived as theoretical. Face shields provide a sufficient barrier against splash and splatter contamination but may be insufficient against aerosols. Additional face masks would provide support against aerosols, but it remains debatable if corneal harvesting can be considered an aerosol-producing procedure. In the future we expect to see changes in current guidelines because of a surge in scientific activities to improve our understanding of the risks involved with cornea donation in the COVID-19 pandemic, and because current practice may reduce the availability of donor corneas due to new exclusion criteria while the demand remains unchanged.
Authors: Diana Wille; Joana Heinzelmann; Astrid Kehlen; Marc Lütgehetmann; Dominik S Nörz; Udo Siebolts; Anke Mueller; Matthias Karrasch; Nicola Hofmann; Anja Viestenz; Martin Börgel; Ferenc Kuhn; Arne Viestenz Journal: J Clin Med Date: 2022-06-09 Impact factor: 4.964