THE INFLUENCE OF DONORS DISEASE ON THE ST ATE OF HUMAN CORNEAS BEFOREAND AFTER ORGAN-CULTURE

Recent studies have shown that the human cornea reflects the metabolic status of the donor. Nevertheless, it has not yet been shown whether this leads to a different tolerance of organ culture and whether these changes are reversible or not. Materials and methods: Eighty-five org an-cultured human corneas were investigated. Endothelial cell density and the concentrations of glucose, lactate, ATP and ADP were determine d in each cornea by enzymatic-optical methods. Obduction protocols wer e examined and five groups of donors could be determined: (1) donors w ho had died suddenly; (2) donors who had died of malignant processes; (3) donors with septicaemia; (4) renal-insufficient donors; and (5) di abetic donors. Results: Endothelial cell density decreased significant ly after 28 days of organ culture. Deswelling for 1 day in a medium co ntaining dextran 500 caused additional cell loss. On the basis of bioc hemical parameters, the corneas showed recovery after organ culture: e specially ATP and ADP concentrations increased. Glucose concentrations decreased and lactate concentration increased in the closed organ cul ture system. Best recovery was observed in corneas from septic donors and from those who had died of carcinoma. Overall, an equalization of all corneas after the culture period was observed. In contrast, the de swelling period causes deterioration of metabolic status; ATP concentr ation decreased dramatically, and ADP increase was higher than expecte d. Conclusion: From these data we conclude that there is no donor dise ase that could lead to exclusion of the cornea from organ culture. In fact, organ culture leads to a recovery of the metabolic status of the human cornea.