[Trends and estimates of regional differences of cornea donation and transplantation in France (1991-1998)]. / Evolution et estimation des disparités régionales des activités de prélèvement et de greffe de cornée en France (1991-1998).

ABSTRACT

PURPOSE: To evaluate national trends of corneal procurement and transplantation, and to estimate regional disparities between the rates of transplantation and patients registered on local waiting lists. METHODS: A questionnaire was sent, every year since 1994, to all the heads of ophthalmology departments in public and private hospitals. RESULTS: After a dramatic decrease in 1992, donations and transplantations then increased to reach 4549 and 4053 in 1998. This increase was mainly observed for cornea retrieval from non heart beating donors in public hospitals. Since 1997, the number of imported corneas has increased, 1016 corneas were imported in 1998 (25% of the corneas transplanted). The estimate of the number of patients registered on local waiting lists decreased to 7400 at the end of 1998. Regional agreement, using the ratio of the number of patients registered on waiting list at the end of 1998 and the number of cornea harvested in 1998 was low for several French regions Aquitaine, Champagne-Ardenne, Nord-Pas-de-Calais, Picardie, Ile-de-France, Rhône-Alpes, Antilles. CONCLUSION: Careful thought and regional efforts pointed at non-heart beating donors should be applied to increase the level of corneal harvesting, and to reduce waiting lists in France to levels similar to those in other European countries. Recent issue of legal authorization of cornea banking and creation in october 1999 of a national waiting list should facilitate these efforts.