Distribution

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 supplied Type 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 Trusts 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