Purpose Croatian Tissue and Cell Bank (CTCB) regularly monitors the effectiveness of cornea donation program on the national level. All hospitals are required to have designated tissue donation coordinators in charge of detection, family interview and tissue procurement. If hospital has cornea donation program only from donors after brain death (DBD), tissue donation coordinator can be the same as for organs. Five collection centres have cornea donation program for donors after circulatory death (DCD) with designated cornea donation coordinators.
Methods We retrospectively analyzed all monthly reports from tissue donation coordinators in the period from May 2019 to September 2022. Additional data was collected from national organ and tissue database Croatian National Transplantation Network (NTM).
Results During the analyzed period, 25.753 deaths were recorded, from which 38,6% to 54,7% of DCD and 0,6% to 1,1% of DBD donors were considered for cornea donation, depending on the hospital. Out of all deceased, 2,4% to 5,2% of patients were realized as cornea donors, 0,4 to 0,5% of which were DBD and 2 to 4,7% were DCD. Cornea donations were realized in 18,2% to 38,9% cases of all DBD donors. As SARS-CoV-2 pandemic has strated in March 2020, the cumulative number of donations declined for 26,1% in 2020 and 12,1% in 2021, compared to the pre-pandemic 2019. Moreover, CTCB received 30,5% less DCD in 2020 and 21,9% less in 2021. Despite that, we recorded increase in DBD during 2020 and 2021, for 13,3% and 44,7%, respectively. The same trend continued throughout 2022, where only until September 16,1% more DBD were received than in the whole 2019.
Conclusion Hospitals involved in cornea donation program record high number of deaths, however only a small proportion of which are realized for cornea donation. This is particularly pronounced in DBD donors. SARS-CoV-2 pandemic left significant impact on donation program. However, CTCB recorded higher number of DBD donors during that period. The current situation leaves plenty of room for improvement of CTCB and corresponding donation hospitals, to increase disproportionately low rate of cornea procurement in respect to the total rate of deaths and considered donors.
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