Eye Banking: The Process from Donor to Recipient
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.
The eye bank contacts the next of kin, as defined by state law and the Uniform Anatomical Gift Act (UAGA), to obtain consent for the donation of the individual's corneas. If consent is given, the next of kin is asked to complete 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.
If there are not any medical "rule outs," an eye bank technician performs a physical inspection of the donor. This physical inspection contributes to the donor profile, and screens for physical signs of infectious disease or behavior that may have put them at risk, such as intravenous drug use. The technician also draws a sample of blood from the donor to be tested for HIV I and II, Hepatitis B and C, and Syphilis.
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 eye to establish a sterile field. After removing the cornea, it is placed in a storage medium to keep the tissue viable and help to reduce bacterial growth. The technician then transports the cornea to the eye bank's laboratory for further 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.
If the medical director or his/her designee authorizes release of the tissue, the cornea is then sealed and packed in a container in 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 or another eye bank for transplant.
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 never know the name of their donor, recipients may choose to write letters of gratitude to their donors’ families, which the eye bank helps to deliver.