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dc.contributor.authorMargo, J.A.
dc.contributor.authorMunir, W.M.
dc.contributor.authorBrown, C.H.
dc.date.accessioned2019-10-08T19:43:54Z
dc.date.available2019-10-08T19:43:54Z
dc.date.issued2017
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85014579950&doi=10.1001%2fjamaophthalmol.2016.5095&partnerID=40&md5=010084f6a524ec1c44406fa8f6290f74
dc.identifier.urihttp://hdl.handle.net/10713/11137
dc.description.abstractIMPORTANCE The rate of types 1 and 2 diabetes in the United States is increasing. The effect of diabetes on corneal donor tissue is unknown. OBJECTIVES To determine the association between endothelial cell density and suitability for transplantation in cornea donors with type 1 or 2 diabetes and determine the effect of diabetes on technician-induced endothelial damage during cornea donor tissue processing. DESIGN, SETTING, AND PARTICIPANTS Donor informationwas obtained from the SightLife Eye Bank for donors from June 1, 2012, to June 30, 2015. The presence of diabetes was determined based on donor medical history. Severe diabetes was classified based on the presence of comorbidities of diabetes. The donor data set contained information on 34 497 donated eyes during the 3-year period, including donor demographics, time from death to refrigeration and preservation of the cornea, endothelial cell count, lens status, medical and surgical history, and suitability for transplantation. MAIN OUTCOMES AND MEASURES Endothelial cell density, suitability for transplantation based on tissue analysis, and technician-induced endothelial damage. RESULTS Among 14 532 donors (mean [SD] age, 58.6 [13.4] years; 8516 men and 6016 women), the mean (SD) endothelial cell count was 2732 (437) cells/mm2. Type 1 or 2 diabetes was listed in the medical history for 8552 of 27 948 donor eyes (30.6%); 5242 eyes (18.8%) were from patients with severe diabetes. After adjusting for age, race/ethnicity, sex, lens status, time from death to refrigeration, and time from death to preservation, the presence of diabetes (adjusted odds ratio, 0.79; 95%CI, 0.51-1.22; P = .28) and severe diabetes (adjusted odds ratio, 95%CI, 0.86; 95%CI, 0.54-1.39; P = .54) were not associated with poor transplant suitability based on results of tissue examination. Donors with diabetes (mean [SD] cell count difference, 9.0 [6.7] cells/mm2; 95%CI,-4.1 to 22.2; P = .18) and severe diabetes (mean [SD] cell count difference, 7.7 [8.1] cells/mm2; 95%CI,-8.1 to 23.6; P = .34) did not exhibit lower cell counts. Technician-induced endothelial damage occurred in 59 corneas (0.2%) but was not associated with the presence of diabetes (adjusted odds ratio, 1.23; 95%CI, 0.66-2.32; P = .52). CONCLUSIONS AND RELEVANCE These data suggest that cornea donors have a high frequency of diabetes. However, this analysis was not able to show that the presence of diabetes was associated with technician-induced endothelial damage, reduced transplant suitability, or reductions in endothelial cell counts. Eye banks may need to collect medical history in a more robust manner. Additional studiesmay be valuable to determine the effect on long-term transplant outcomes of diabetes in cornea donors.en_US
dc.description.urihttps://doi.org/10.1001/jamaophthalmol.2016.5095en_US
dc.language.isoen_USen_US
dc.publisherAmerican Medical Associationen_US
dc.relation.ispartofJAMA Ophthalmology
dc.subjecteye donorsen_US
dc.subject.meshEndothelial Cellsen_US
dc.subject.meshCorneaen_US
dc.subject.meshTransplantsen_US
dc.subject.meshDiabetes Mellitus, Type 1en_US
dc.subject.meshDiabetes Mellitus, Type 2en_US
dc.subject.meshEye Banksen_US
dc.titleAssociation between endothelial cell density and transplant suitability of corneal tissue with type 1 and type 2 diabetesen_US
dc.typeArticleen_US
dc.identifier.doi10.1001/jamaophthalmol.2016.5095
dc.identifier.pmid28033432


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