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Distribution

Distribution. UKT holds a national waiting list for patients in need of scheduled grafts, as well as tissue-matched corneal transplants list Supply of ocular tissue for emergencies. Benefits of organ culture as a corneal storage procedure (I). Scheduled corneal grafts

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Distribution

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  1. Distribution • UKT holds a national waiting list for patients in need of scheduled grafts, as well as tissue-matched corneal transplants list • Supply of ocular tissue for emergencies

  2. Benefits of organ culture as a corneal storage procedure (I) • Scheduled corneal grafts • Beneficial to patients and hospital staff • Saves money for NHS • Majority of corneal transplants are performed as elective surgery on routine theatre lists. This results in greater number of transplants performed

  3. Benefits of organ culture as a corneal storage procedure (II) • Supply of corneas for emergencies • Routine screening for virology and microbiology • Completion of donor information • Evaluation of corneal endothelium • Time for transport for recipient center • Reduced tissue wastage

  4. Ocular tissue for transplantation Tissue suppliedType of graft Corneoscleral disc Full thickness penetrating keratoplasty Corneoscleral disc Partial thickness - anterior lamellar - deep anterior lamellar - endothelial keratoplasty Corneoscleral disc -Limbal stem cell allograft sclera -Reconstruction, orbital implants

  5. Allocation and distribution of tissue • All ocular tissue supplied by the CTS Eye Banks for clinical use is distributed through UKT according to Department of Health guidelines • Requests for tissue are made to UKT and are accepted only for named patients • Unmatched transplants • HLA-matched transplants • Corneas for emergency requests • Unused corneas • Sclera • Confirmation of use of tissue

  6. Follow up • Ocular tissue transplant audit • Since April 1999, follow-up data have been collected through the UKT/RCOphth Ocular Tissue Audit

  7. Data summary 2006-2007: • Corneas received in the MEB: 2143 • Tissue issued for grafts: • Corneas: 1312 • Sclerae: 185

  8. Adverse incidents and adverse reactions • Communicated through • UKT • medical advisor • or directly to CTS-EBs

  9. Adverse reactions • Patient developed CJD • Herpes infection

  10. Adverse reactions report • Report investigated by DI • Report of incident and investigation to medical advisor: communicate to OTAG and OTTSG • Report to HTA online • Report to LH through HTA steering group • Report to Trust’s incidents report system

  11. Future • Better trained workforce in eye retrieval • Improve levels of donation – improvement in quality of tissue • Reduce adverse incidents • Continuous training of staff on HTA issues • Safety of tissue for transplantation

  12. Aknowledgements • BEB. Prof. John Armitage, Paul Bowerman • BATB. Ruth Warwick • CMMC HTA Steering Group. Martin Hodgson • NRC-TS. Jane Pearson • UKT. David Shute, Sue Falvey, Neil Stapleton, Mark Jones • HTA. Dr. Sandy Mather, Kristi Collins

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