P31-A150†SARS-CoV-2 real time polymerase chain reaction testing of corneas from post-mortem SARS-CoV-2 positive donors.

PURPOSE: Possible transmission of SARS-CoV-2 from donors to recipients via cornea grafts is still a concern of the transplantation community. Current recommendations are to avoid corneal transplants from donors with ongoing SARS-CoV-2 infection or those recently exposed to it. During pandemic period in Croatia 21/1113; (1,9%) corneas were procured from donors positive for SARS-CoV-2 by postmortem nasopharyngeal swab tests. That tissue was discarded. Due to the lack of knowledge about the infectivity of such corneas, we started prospective study of SARS-CoV-2 presence in cornea tissue. Here we show our first results. METHODS: In the study period we had four corneas procured from two post-mortem SARS-CoV-2 positive donors. For the presence of SARS-CoV-2, analysis is performed on donor serum, hypothermic storage medium and cornea tissue lysate. Corneas were stored in hypothermic condition for 8 to 10 days, after which tissue was macerated and washed with PBS. The intracellular content was released by incubation with lysis buffer, followed by centrifugation. Next, tissue lysate, serum and hypothermic storage medium were in parallel subjected to fully automated nucleic acid isolation and RNA expression was analyzed by qRT-PCR. During isolation, RNasaP was used as internal control for successful nucleic acids isolation. RESULTS: No SARS-CoV-2 RNA was detected in the donors serum, storage medium and cornea tissue from donors who were SARS-CoV-2-positive upon tissue procurement. In nasopharyngeal swabs of post mortem positive donors cycle threshold values of viral copies were high (CT>34), indicating that there was small number of viral particles in infected donors that could have impact on negative results in tested tissue. CONCLUSION: Our data suggested that corneas may not be SARS-CoV-2 permissive if the donor was postmortem positive. Further research is required to gain more coherent insight into SARS-CoV-2 transmission via corneal transplantation.

P39-A145†Analysis of cornea donation program in croatia.

PURPOSE: Croatian Tissue and Cell Bank (CTCB) regularly monitors the effectiveness of cornea donation program on the national level. All hospitals are required to have designated tissue donation coordinators in charge of detection, family interview and tissue procurement. If hospital has cornea donation program only from donors after brain death (DBD), tissue donation coordinator can be the same as for organs. Five collection centres have cornea donation program for donors after circulatory death (DCD) with designated cornea donation coordinators. METHODS: We retrospectively analyzed all monthly reports from tissue donation coordinators in the period from May 2019 to September 2022. Additional data was collected from national organ and tissue database Croatian National Transplantation Network (NTM). RESULTS: During the analyzed period, 25.753 deaths were recorded, from which 38,6% to 54,7% of DCD and 0,6% to 1,1% of DBD donors were considered for cornea donation, depending on the hospital. Out of all deceased, 2,4% to 5,2% of patients were realized as cornea donors, 0,4 to 0,5% of which were DBD and 2 to 4,7% were DCD. Cornea donations were realized in 18,2% to 38,9% cases of all DBD donors. As SARS-CoV-2 pandemic has strated in March 2020, the cumulative number of donations declined for 26,1% in 2020 and 12,1% in 2021, compared to the pre-pandemic 2019. Moreover, CTCB received 30,5% less DCD in 2020 and 21,9% less in 2021. Despite that, we recorded increase in DBD during 2020 and 2021, for 13,3% and 44,7%, respectively. The same trend continued throughout 2022, where only until September 16,1% more DBD were received than in the whole 2019. CONCLUSION: Hospitals involved in cornea donation program record high number of deaths, however only a small proportion of which are realized for cornea donation. This is particularly pronounced in DBD donors. SARS-CoV-2 pandemic left significant impact on donation program. However, CTCB recorded higher number of DBD donors during that period. The current situation leaves plenty of room for improvement of CTCB and corresponding donation hospitals, to increase disproportionately low rate of cornea procurement in respect to the total rate of deaths and considered donors.