Corneal Transplantation From Donors With a Documented History of Suspected Sepsis: Infectious Risks and Graft Outcomes
William R. Herskowitz, Robert C. O'Brien, Ansu A. John, Aaron R. Harris, Sofia E. Parellada, Sarah Pajek, Vivian C. Lopez, Elizabeth Fout, William Buras, Sander R. Dubovy, Ellen H. KooPurpose:
To evaluate infectious risk and clinical outcomes of corneal transplantation using tissue from donors with a documented history of suspected sepsis (DSS).
Methods:
A retrospective study (2020–2024) was conducted using the iTransplant database and electronic health records at a single tertiary center. Donors with documented sepsis, severe sepsis, septic shock, bacteremia, fulfillment of systemic inflammatory response syndrome criteria, or physician concern for sepsis were identified and characterized. All donors were cleared for transplantation without evidence of active systemic infection at the time of death. Corneoscleral rim culture positivity and associated infections were assessed across all transplant recipients. A subset of 156 eyes (48 DSS donors, 108 control donors) was analyzed for clinical outcomes, including graft survival, best-corrected visual acuity, central corneal thickness, and graft clarity.
Results:
Among 1331 donors, 145 (10.9%) had DSS. Across 2583 corneal transplants, 11 positive rim cultures were identified, including 3 from DSS donors. Two cases of
Conclusions:
Corneal transplantation using tissue from DSS donors demonstrates low infectious risk and comparable clinical outcomes to non-DSS donors.