학술논문
Semiautomatic assessment of endothelial density and morphology in organ-cultured corneas - potential predictors for transplantation suitability and clinical outcome?
Document Type
Academic Journal
Author
Filev F; Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany. flip_flev@yahoo.com.; Department of Ophthalmology, Werner Forssmann Hospital, Eberswalde, Germany. flip_flev@yahoo.com.; Stein M; Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany.; Schultheiss M; Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany.; Fitzek ADE; Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany.; Feuerstake J; Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany.; Engel O; Department of Urology, Asklepios Klinikum Harburg, Eißendorfer Pferdeweg 52, 21075, Hamburg, Germany.; Hellwinkel OJC; Department of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Martitistr. 52, 20246, Hamburg, Germany.
Source
Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 8205248 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1435-702X (Electronic) Linking ISSN: 0721832X NLM ISO Abbreviation: Graefes Arch Clin Exp Ophthalmol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The quality of the endothelial cell layer is a major criterion for the approval of organ-cultured human donor-corneas for transplantation. We wanted to compare the predictive capacities of initial endothelial density and endothelium cell morphology for the approval of donor corneas for transplantation and for the clinical outcome after transplantation.
Methods: The endothelial density and endothelium morphology in organ culture were examined by semiautomatic assessment of 1031 donor corneas. We performed a statistical analysis for correlations of donor-data and cultivation parameters regarding their predictive capacities for the final approval of donor corneas for transplantation and the clinical outcome of 202 transplanted patients.
Results: Corneal endothelium cell density proved to be the only parameter with a certain predictive capacity with regard to the final decision, whether donor corneas are suitable for transplantation - however, the correlation was low (area under the curve [AUC] = 0.655). Endothelial cell morphology lacked any predictive power (AUC = 0.597). The clinical outcome regarding visual acuity seemed to be largely independent from both corneal endothelial cell density and morphology. Sub-analyses on transplanted patients stratified for their diagnoses vindicated these findings.
Conclusions: Higher endothelial density (above a cut-off level of 2000 cells/mm2 ), as well as better endothelial morphology do not seem to be critical for transplant-corneal functionality in organ culture and up to 2 years after transplantation. Comparable long-term studies on graft survival are recommended to determine, whether the present endothelial density cut-off levels might be too stringent.
(© 2023. The Author(s).)
Methods: The endothelial density and endothelium morphology in organ culture were examined by semiautomatic assessment of 1031 donor corneas. We performed a statistical analysis for correlations of donor-data and cultivation parameters regarding their predictive capacities for the final approval of donor corneas for transplantation and the clinical outcome of 202 transplanted patients.
Results: Corneal endothelium cell density proved to be the only parameter with a certain predictive capacity with regard to the final decision, whether donor corneas are suitable for transplantation - however, the correlation was low (area under the curve [AUC] = 0.655). Endothelial cell morphology lacked any predictive power (AUC = 0.597). The clinical outcome regarding visual acuity seemed to be largely independent from both corneal endothelial cell density and morphology. Sub-analyses on transplanted patients stratified for their diagnoses vindicated these findings.
Conclusions: Higher endothelial density (above a cut-off level of 2000 cells/mm
(© 2023. The Author(s).)