Understanding Donation

The cornea is the transparent, outermost layer of the eye that provides protection and about two-thirds of the refractory power of the eye. When the cornea becomes diseased or scarred, a transplant is needed. During a corneal transplant, the unhealthy cornea is replaced with a donor cornea. It is the eye bank that facilitates this important process.

Woman with eye open in hospital and surgeon with medical equipment

 

“Restoring sight to patients suffering from corneal blindness is only made possible through cornea donation. The process of cornea donation starts with an individual’s decision to be an eye, tissue, and organ donor. This can be done when renewing their driver’s license,  registering at donatelifearkansas.org, or a family’s consent to donation. Donation then results in a corneal transplant for a patient suffering from corneal blindness.” – EBAA

What is an Eye Bank?

According to the Eye Bank Association of America, an eye bank is a non-profit organization that obtains, medically evaluates, and distributes eyes donated by caring individuals for use in corneal transplantation, research, and education. U.S. eye banks provide tissue for an average of nearly 85,000 corneal transplants a year.

Different types of Eye Bank Structures

  • Eye Bank Only Functions
  • Tissue and Eye Bank Functions
  • Recovery Centers
  • Processing Centers
  • Distribution Centers
  • Multi-center Eye Banks

Departments within an Eye Bank

  • Quality Assurance
  • Technical
    • Tissue Recovery
    • Processing
    • Preparing tissue for various corneal transplant procedures
  • Donor Development
    • Build and strengthen relationships with the community, hospitals, hospices, funeral homes, and other third party organizations.

The Process from Donor to Recipient

The Call

An eye bank receives a call from a hospital, an organ procurement organization, or another third party that an individual has died and has met preliminary criteria for donation. The eye bank has a very short time within which to contact the next of kin, obtain consent, and recover the tissue. This generally needs to happen within 12 hours of the time of death.

Consent and Medical Review

If the individual is a registered organ/eye/tissue donor, in most cases the eye bank can immediately proceed to recover his/her corneas. Otherwise, the eye bank contacts the next of kin to obtain consent for donation. In either case, the eye bank will contact the next of kin to obtain a medical-social history. The medical-social history provides the eye bank with information to make a donor eligibility determination. The eye bank also obtains copies of relevant medical records from the hospital, paying close attention to the cause of death, any medications that were administered to the individual and the circumstances of his/her death.

Physical Inspection of the Donor

If there are not any medical “rule outs,” an eye bank technician will travel to the donor’s location (typically a hospital or morgue) to recover his/her corneas. The first step is a physical inspection of the donor. This contributes to the donor profile, and screens for signs of infectious disease or behavior that may have put them at risk, such as intravenous drug use. The technician also draws a blood sample to be tested for HIV, Hepatitis, Syphilis and other blood-borne diseases.

Recovery

The donor’s eyes are then prepared for the procedure to recover the cornea. The technician dons a sterile gown and gloves, and drapes the donor’s eyes to establish a sterile field. After removing the cornea, it is placed in a storage medium to keep the tissue viable. The technician then transports the cornea to the eye bank’s laboratory for further evaluation.

Evaluation

Specially trained technicians evaluate the cornea through microscopes to check for damage or deformities and to ensure that it meets the eye bank’s strict criteria for transplantation. The eye bank’s medical director or his/her designee reviews this information, as well as the donor’s medical records and makes a final eligibility determination.

Release of Tissue

If the medical director or his/her designee authorizes release of the tissue, the cornea is then sealed and packed in a container of wet ice (to ensure it remains between 2-8 degrees and does not freeze). The cornea is labeled with a unique identification number to allow the eye bank to track the tissue from donor to recipient. It is then shipped to a surgeon for transplant.

Post-Donation Support

Eye banks recognize the incredible generosity of cornea donors and their families, and may offer a variety of programs to provide support and/or to honor their sacrifice. While corneal transplant recipients will not be told the name of their donor, they may choose to write letters of gratitude to their donors’ families, which the eye bank helps to deliver.

Source: Eye Bank Association of America  http://restoresight.org