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The role of corneal endothelial morphology in graft assessment and prediction of endothelial cell loss during organ culture of human donor corneas
Author(s) -
Hermel Martin,
Salla Sabine,
Fuest Matthias,
Walter Peter
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13108
Subject(s) - endothelial stem cell , endothelium , cell culture , andrology , organ culture , medicine , cornea , pleomorphism (cytology) , ophthalmology , biology , surgery , pathology , immunohistochemistry , biochemistry , in vitro , genetics
Purpose Endothelial assessment is crucial in the release of corneas for grafting. We retrospectively analysed the role of endothelial morphology parameters in predicting endothelial cell loss during organ culture. Methods Human donor corneas were cultured in minimal essential medium with 2% fetal calf serum and antibiotics. Initial endothelial morphology was assessed microscopically using score parameters polymegethism ( POL ), pleomorphism ( PLE ), granulation ( GRA ), vacuolization ( VAC ), segmentation of cell membranes ( SEG ), Descemet's folds ( DF ), trypan blue‐positive cells ( TBPC ) and endothelial cell‐free areas ( ECFA ). Some corneas were primarily rejected based on endothelial assessment. Endothelial cell density ( ECD ) was assessed at the beginning (I‐ ECD ) and end of culture. Corneas were then placed in dehydration medium (as above + 5% dextran 500). In a subgroup, ECD was reassessed after dehydration. Endothelial cell loss during culture ( ECL @Culture) and culture+dehydration ( ECL ‐Culture&Dehydration) were calculated. Data were given as mean ± SD and analysed using multiple linear and logistic regression. Odds ratios ( OR ) and 95% confidence intervals ( CI ) were calculated. Result I‐ ECD was 2812 ± 360/mm 2 ( n = 2356). The decision to reject a cornea due to endothelial assessment was associated negatively with I‐ ECD ( OR = 0.77/100 cells, CI 0.7–0.82) and positively with ECFA ( OR = 2.7, CI 1.69–4.35), SEG ( OR =1.3, CI 1.01–1.68) and donor age ( OR = 1.26/decade, CI 1.33–1.41). ECL @Culture was 153 ± 201/mm 2 ( n = 1277), ECL @Culture&Dehydration was 169 ± 183/mm 2 ( n = 918). ECL @Culture was associated positively with donor age, I‐ ECD , GRA and TBPC , and negatively with PLE , and DF . ECL @Culture&Dehydration was associated positively with age, sex, initial ECD , POL , PLE , VAC and TBPC . Conclusion Morphological parameters displayed associations with the exclusion of corneas from culture and with endothelial cell loss. Appropriate parameter selection for screening purposes may help improve graft quality.