부산대학교 도서관

Objective: Control of corneal damage with endothelial cell count and serological screening before keratoplasty are critical issues for recipient health. We aimed to detect the pre-transplantation hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), and Treponema pallidum serological test results of post-mortem corneal donors and to determine their correlation with serological and molecular tests to support or verify low reactive/positive test results. Methods: The serological test results of post-mortem corneal donors sent from the eye bank between January 2015 and December 2020 were analyzed retrospectively, and demographic and serological test data of these donors were obtained from ELISA laboratory data by the ISHOP system Cerrahpasa Medical Faculty Hospital. Results: Of 424 post-mortem corneal donors, 161 (37.7%) were female, and 263 (62.03) were male; 13 (3.06%) had high HBsAg positivity, 23 (5.42%) had low anti-HCV reactivity, 19 (4.48%) had low anti-HIV 1/2 reactivity, and two (0.47%) had high Tp-Ab IgG reactivity. Therefore, the corneas of a 30-year-old woman with positive HCV RNA result and 13 donors with high titer HBsAg positivity, and two donors with high reactivity in the Tp-Ab IgG test were not eligible for the Eye Bank after performing a real-time PCR assay for the confirmation of donors with low reactivity. Conclusion: We believe that it is essential to apply serological tests pre-keratoplasty to prevent infection transmission and perform confirmatory tests in low positivity/reactivity that may occur due to postmortem coagulum hemolysis, within the framework of a collective and specific algorithm. Keywords: Keratoplasty, HBV, HCV, HIV, Treponema pallidum Amac: Keratoplasti oncesi korneada hasar kontrolunun yapilmasi, endotel hucre sayimi ile birlikte serolojik taramalarda insan sagligi icin oldukca onem arz etmektedir. Bu nedenle calismamizda; postmortem kornea donorlerinin, transplantasyon oncesi hepatit B virusu (HBV), hepatit C virusu (HCV), insan bagisiklik yetmezligi virusu (HIV) ve Treponema pallidum serolojik test sonuclarini ortaya koymak ve ozellikle dusuk reaktif/pozitif test sonuclarini desteklemek veya dogrulamak icin serolojik ve molekuler testlerle korelasyonunun saptamak amaclandi. Yontemler: Ocak 2015-Aralik 2020 tarihleri arasinda goz bankasindan gonderilen postmortem kornea donorlerinin serolojik test sonuclari retrospektif olarak incelendi. Donorlerin demografik ve serolojik test verilerine Cerrahpasa Tip Fakultesi Hastanesinin ISHOP sistemi Elisa Laboratuvari verilerinden ulasildi. Bulgular: Toplam 424 postmortem kornea donorunun 161 (%37.7)'i kadin, 263 (%62.03)'u erkekti. Yapilan tarama sonucunda 424 donorun 13 (%3.06)'unde HBsAg yuksek pozitiflik, 23 (%5.42)'unde anti-HCV dusuk reaktiflik, 19 (%4.48)'unda anti-HIV 1/2 dusuk reaktiflik ve 2 (%0.47)'sinde Tp-Ab IgG yuksek reaktiflik saptandi. Dusuk reaktivite saptanan donorlerde dogrulama amacli yapilan gercek zamanli polimeraz zincir reaksiyonu (RT-PCR) testi sonucunda HCV RNA'si pozitif olan 30 yasindaki bir kadin donorun, HBsAg yuksek titrede pozitiflik alan 13 donorun ve Tp-Ab IgG test sonucu yuksek reaktiflik saptanan 2 donorun kornealari goz bankasi tarafindan kullanilamamistir. Sonuc: Kornea transplantasyonu oncesi mikrobiyolojik bulasmalari onlemek icin yapilan serolojik testler ile postmortem koagulum hemolizi nedeniyle meydana gelebilen dusuk pozitiflik/reaktiflik durumundan kaynakli olarak yapilan dogrulama testlerinin ortak ve belirli bir algoritma cercevesinde uygulanmasi oldukca onemlidir. Anahtar Kelimeler: Kerotoplasti, HBV, HCV, HIV, Treponema pallidum
GIRIS Keratoplasti olarak da adlandirilan kornea nakli ilk kez 1905 yilinda Eduard Konrad Zirm tarafindan yapilmis olup o zamandan bu yana en sik yapilan nakil turudur (1). Korneanin tam kalinlikta [...]