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Eye Banking and Corneal Transplantation Communicable Adverse Incidents: Current Status and Project NOTIFY

Dubord, Paul J. MD*; Evans, G. Dewey PhD; Macsai, Marian S. MD†,‡; Mannis, Mark J. MD, FACS§; Glasser, David B. MD; Strong, Douglas M. PhD; Noël, Luc MD**; Fehily, Deirdre PhD††

doi: 10.1097/ICO.0b013e31828f9d64
Special Article

Purpose: Evidence of the transmission of disease via donor ocular tissue has been demonstrated for adenocarcincoma, rabies, hepatitis B virus, cytomegalovirus, herpes simplex virus, Creutzfeldt-Jakob disease, and a variety of bacterial and fungal infections.

Methods: Although there is no evidence to date of disease transmission for HIV infection, syphilis, hepatitis C, hepatitis A, tuberculosis, HTLV-1 and -2 infection, active leprosy, active typhoid, smallpox, and active malaria, these entities remain contraindications for transplantation for all eye banks nationally and internationally. The potential sources of contamination include infected donors, during the process of removing tissue from cadaveric donors, the processing environment, and contaminated supplies and reagents used during processing. The transmissions of Herpes simplex virus and HSV via corneal graft have been shown to be responsible for primary graft failure. HSV-1 may also be an important cause of PFG.

Results: The long latency period of some diseases, the emergence of new infectious disease, and the reemergence of others emphasize the need for long-term record maintenance and effective tracing capabilities.

Conclusions: The standardization of definitions for adverse events and reactions will be necessary to support the prevention and transmission of disease. International classification of a unique identification system for donors will be increasingly important for vigilance and traceability in cross-national exportation of human cells, tissues, and cellular- and tissue-based products. Opportunities for continuous improvement exist as does the need for constant vigilance and surveillance.

*Department of Ophthalmology and Visual Sciences, University of British Columbia, British Columbia, Canada;

University of Chicago Pritzker School of Medicine, Chicago, IL;

NorthShore University HealthSystems, Evanston, IL;

§University of California Davis Health System Eye Center, Sacramento, CA;

Johns Hopkins University School of Medicine, Baltimore, MD;

Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, Seattle, WA;

**Department for Health Systems Policies and Workforce, World Health Organization, Geneva-HQ, Geneva, Switzerland; and

††National Italian Transplant Centre, Italian National Institute of Health, Italy, Rome.

Reprints: Paul J. Dubord, 1603-805 West Broadway, Vancouver, BC V5Z 1K1, Canada (e-mail: paul@pjdubord.com).

The authors have no funding or conflicts of interests to disclose.

Received October 25, 2012

Accepted February 27, 2013

© 2013 by Lippincott Williams & Wilkins.