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Performance Analysis of Efforts Towards Promotion of Corneal Donation at a Tertiary Care Trauma Center in India

Performance Analysis of Efforts Towards Promotion of Corneal Donation at a Tertiary Care Trauma Center in India

Kumar, Adarsh MD; Kumar, Arvind MD; Bali, Shveta J. MD; Tandon, Radhika MD, FRCS, FRCOphth

Purpose: To identify the number of potential donors from trauma-related deaths and examine the extent of loss of opportunity at different levels for eye donation.

Methods: A retrospective review of the death records from the mortuary of Jai Prakash Narayan Apex Trauma Centre and National Eye Bank at All India Institute of Medical Sciences was conducted for the period between January 2008 and August 2009. All cases with trauma-related deaths were included in the study. Cases with known contraindications to eye donation were excluded from the study. The main outcome measure was “lost opportunity cases” where the families of eligible donors were not approached. The secondary outcome measure was successful procurement rate.

Results: The total number of trauma-related deaths noted during the study period was 1584. One hundred cases were excluded from the study because the records were either incomplete or not readily available. A total of 1066 cases were identified as medically suitable potential eye donors. The death–autopsy interval was 12 hours or less in 425 cases and >12 hours in 641 cases. Among eligible donors, there were 831 (78%) lost opportunity cases. Among 235 families approached, only 20 (8.5%) agreed to eye donation. Overall, successful eye donation was possible in only 20 (1.9%) of the eligible trauma-related deaths.

Conclusions: Trauma-related deaths form a major pool for potential tissue donors. Only about one fifth of the medically eligible cases could be approached for counseling. A potentially large donor pool of trauma-related deaths is compromised by the lost opportunity cases and the low donation rate. Efforts are needed to augment existing administrative and manpower resources to increase the corneal procurement rate in the Indian population.