Our Summary

A team in Switzerland, led by the national foundation coordinating organ and tissue donations - Swisstransplant (SWT), has developed a list of conditions that would disqualify someone from donating their corneas after death. This list was created after a series of meetings where they reviewed national and international guidelines, while also keeping Swiss laws and transplant regulations in mind.

If the group had disagreements, they would continue discussing until they all agreed. From March to November 2021, they held six meetings and finally came up with a minimal list of contraindications for corneal donation in Switzerland. This list is now a required tool for coordinators who evaluate potential donors for corneal donation.

It’s important to note that while this national list provides a standard, local eye banks can decide to use more strict criteria if they want.

Since corneal transplantation is the most commonly performed transplantation, it’s crucial to have a clear understanding of when it’s not safe to use a donated cornea. This list is a significant step in making sure the quality of donated corneas is high and there are enough safe donor tissues available in the country. The team believes it’s important to regularly review and update this list.

FAQs

  1. Who developed the list of conditions that would disqualify someone from donating their corneas after death in Switzerland?
  2. How does the national list of contraindications for corneal donation in Switzerland affect local eye banks?
  3. Why is it important to have a clear understanding of when it’s not safe to use a donated cornea?

Doctor’s Tip

One helpful tip a doctor might tell a patient about corneal transplant is to ensure they are aware of the criteria for corneal donation and the importance of following these guidelines to ensure the safety and effectiveness of the transplant procedure. Patients should also be encouraged to discuss any concerns or questions they may have with their healthcare provider before undergoing a corneal transplant.

Suitable For

Patients who are typically recommended for corneal transplant include those with conditions such as:

  1. Keratoconus: a progressive thinning of the cornea that causes it to bulge outward, leading to distorted vision.
  2. Fuchs’ dystrophy: a condition where the inner layer of the cornea (endothelium) becomes damaged, leading to fluid buildup and cloudy vision.
  3. Corneal scarring: caused by injuries, infections, or other conditions that result in opaque areas on the cornea.
  4. Corneal ulcers: open sores on the cornea that can lead to vision loss if not treated promptly.
  5. Keratitis: inflammation of the cornea, often caused by infections or contact lens misuse.
  6. Corneal degeneration: a group of disorders that cause the cornea to become weak or thin, leading to vision problems.
  7. Previous corneal transplant rejection: patients who have previously undergone a corneal transplant that was rejected may be recommended for a repeat transplant.

It’s important for patients to undergo a thorough evaluation by an ophthalmologist to determine if they are suitable candidates for corneal transplant surgery. Additionally, patients must be willing and able to follow post-operative care instructions to ensure the success of the transplant.

Timeline

Before corneal transplant:

  • Patient experiences vision problems such as blurry vision, glare, and sensitivity to light
  • Patient undergoes a comprehensive eye exam to determine if a corneal transplant is necessary
  • Patient is placed on a waiting list for a suitable donor cornea
  • Patient undergoes pre-operative evaluations and tests to ensure they are a suitable candidate for the transplant

After corneal transplant:

  • Patient undergoes the corneal transplant surgery, which involves replacing the damaged cornea with a healthy donor cornea
  • Patient is monitored closely for any signs of rejection or complications following the surgery
  • Patient may need to take medications to prevent rejection of the donor cornea
  • Patient undergoes follow-up appointments to monitor the success of the transplant and make any necessary adjustments to the treatment plan

Overall, the timeline for a patient before and after corneal transplant can vary depending on the individual’s specific condition and response to treatment.

What to Ask Your Doctor

  1. What are the risks and potential complications associated with corneal transplant surgery?
  2. How long is the recovery process after a corneal transplant?
  3. How successful are corneal transplants in improving vision?
  4. What is the likelihood of rejection of the donor cornea and how is this managed?
  5. Are there any lifestyle changes or restrictions I should follow after a corneal transplant?
  6. How often will I need to follow up with my doctor after the surgery?
  7. What is the expected lifespan of a donor cornea?
  8. Are there any specific criteria or conditions that would disqualify me from receiving a corneal transplant?
  9. What is the process for obtaining a donor cornea and how is the quality of the donor tissue ensured?
  10. Are there any alternative treatment options to consider before opting for a corneal transplant?

Reference

Authors: Blaser F, Immer F, Kruegel N, Franscini N, Tappeiner C, Rennesson C, Massa H, Reinshagen H, Früh B, Kaufmann C, Meneau I, Said S. Journal: Klin Monbl Augenheilkd. 2024 Apr;241(4):412-416. doi: 10.1055/a-2211-9614. Epub 2024 Apr 23. PMID: 38653295