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Donor Screening Criteria
The document focuses on donor screening and selection processes for corneal transplantation to prevent disease transmission and ensure the quality of corneal tissue. It outlines various contraindications for eye retrieval, including systemic and local infections, malignancies, and neurological diseases, as well as the importance of thorough history taking and serological testing. The key takeaway emphasizes the need for careful documentation and evaluation for each donor.
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Donor Screening Criteria
- 1. Donor Screening and Selection Dr.Pooja Bandivadekar Senior Resident National Eye Bank Rajendra Prasad Center for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi, India
- 2. Aim • Prevention oftransmission of diseases from donor to patient • Provision of optimal quality of corneal tissue for transplantation
- 3. Overview Contraindications For Eye Retrieval/Use Donor Screening- Serological Tests
- 4. Contraindications For Eye-call/ Retrieval Systemic Causes Local Causes Malignancies Systemic Infections Miscellaneous Ocular Infections Ocular Malignancies Neurological Diseases
- 5. Systemic Infections- Contraindications •HIV • Hepatitis B • Hepatitis C • Syphilis • Rabies • Tetanus • Active Malaria • Miliary Tuberculosis • Viral Diseases like Dengue • Active viral hepatitis • Active viral encephalitis • Active meningitis
- 6. Systemic Infections- Contraindications •Septicemia ▫ Total leucocyte count > 14,000 cells/ml ▫ Fever ▫ Positive Blood Culture • Treatment with antibiotics • Resolution of pyrexia • Normalization of Leucocyte count
- 7. Systemic Infections- HistoryTaking • Cause of death • Hospitalization • Intravenous medications and fluids • Blood/ Blood component transfusion • Ventilator Support • High risk behavior • Recreational drugs abuse • Tattooing • Body piercing Supplemented with examination !!!! Supplemented with Documentation !!!!
- 8. Case Scenario 21 yearold male donor- Cause of Death- CRA Cardio- respiratory arrest is only a terminal event What was the preceding event before CRA ? Infection? Trauma? Malignancy? Unknown etiology? Dialogue with treating physician and relatives Proper documen- tation
- 9. Systemic Malignancies-Contraindications • Hodgkin'sDisease/ Lymphoma • Leukaemia • Lymphosarcoma • Multiple Myeloma • Myeloproliferative Disease Not All Malignancies Are Contraindications !
- 10. Neurological Diseases • Alzheimer'sDisease • Dementia of unknown cause • Multiple Sclerosis • Parkinson’s Disease • Creutzfeld -Jacob Disease • Unknown neurological diseases
- 11. Neurological Diseases- HistoryTaking • Transmission of prion diseases- Small but real risk • No serological test for detection • Onset and progression of neurological disease • Travel to/ treatment in European countries
- 12. Ocular Pathologies • Conjunctivitis •Corneal ulcer • Corneal ectatic disorders • Previous corneal surgery • Corneal Scars Not Every Ocular Surgery Is A Contraindication !
- 13. Ocular Malignancies • Retinoblastoma •Malignant melanoma • Ocular surface squamous neoplasia • Metastatic tumour in the eye
- 14. Contraindications- Other causes •Death due to unknown cause • Patients on ventilators > 72 Hours • Cyanide poisoning • Death- preservation time > 24 hours
- 15. Donor Screening Serological tests HIV1&2 HbSAg HCV antibody Syphilis
- 16. Processing Of BloodSample
- 17. Processing Of BloodSample
- 18. What If AnyTest Is Positive ? • Label the cornea as Biohazard • Unsuitable for transplant • Unsuitable for research purpose • Discard through the hospital waste disposal system
- 19. Take Home Message •Careful, sympathetic and appropriate elicitation of history • Careful documentation of cause of death • Serological evaluation in every single donor