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Bramstedt KA. Human Whole-Eye Donation for Research-Optimizing Clinical Trial Informed Consent. JAMA Ophthalmol 2024; 142:476-479. [PMID: 38512234 DOI: 10.1001/jamaophthalmol.2024.0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Importance Posthumous whole-eye (globe) donations for research lack a mechanism that reinvolves the existing ophthalmic research team of the donor unless there is a preplanned donor directive. Disconnection between the deceased and their research team equates to lost opportunities for the research team to have a longitudinal view of the eyes that have been involved in their research. Objectives To use the clinical trial informed consent process to create a posthumous research donation opportunity that directs the donation to the currently affiliated research team of the donors (preserving the longitudinal research experience). Evidence Reviewed Current globe donation pathways were reviewed. Additionally, published advice from the fields of ophthalmology, brain banking, and implantable medical devices were used as reference points. Findings Globe donation represents a small but valuable type of ocular donation. Globe donation for research purposes is useful for investigators performing total human eye allotransplantation clinical trials, as well as for ophthalmic drug or device researchers. Results suggest that those performing invasive eye research should include the option of posthumous globe donation in their study protocols and informed consent forms to facilitate more opportunities for the generation of scientific knowledge. Conclusions and Relevance The longitudinal perspective can be valuable especially for eyes that have received long-term treatment with an investigational drug or device. This article poses a research-informed consent framework for posthumous globe donation.
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Affiliation(s)
- Katrina A Bramstedt
- Global Head of Bioethics, Bioethics Department, F. Hoffmann-La Roche AG, Basel, Switzerland
- Bond University Medical Program, Gold Coast, Queensland, Australia
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Corsi CAC, Assunção-Luiz AV, Cintra ÁS, De Almeida EC. Models of Quality Management Systems Applied in Specialized Services for the Donation and Transplantation of Human Organs and Tissues. Transplant Proc 2023; 55:1337-1345. [PMID: 36990886 DOI: 10.1016/j.transproceed.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 01/26/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Quality management tools and models are used to improve processes and products, including those related to organ and tissue donation and transplantation protocols. This study aims to map, discuss, and disseminate models/tools of quality management systems applied in health services, specializing in the donation and/or transplantation of human organs and tissues. METHODS This is an integrative literature review over the last 10 years, operationalized through searches carried out on the PubMed portal and the databases: SciVerse Scopus (SCOPUS), Scielo, Latin American and Caribbean Literature on Health Sciences (LILACS), Nursing Database (BDENF), and the Virtual Health Library (BVS). The organization of search results in the databases and the election of articles compatible with the guiding question and the inclusion and exclusion criteria for this study took place through the online and free application platform Rayyan. RESULTS Six hundred seventy-eight records were found, of which, after careful analysis, 18 articles were considered relevant to the theme. We identified 17 quality management models and/or tools that emphasize using scientifically proven and/or validated techniques to reduce or eliminate the possibility of risks in the processes that permeate the stages of donation and transplantation of organs and tissues. CONCLUSION This review brought the possible tools used and published, which can be perceived, reproduced, and improved, through the role of the multidisciplinary team in specialized centers for the donation and transplantation of human organs and tissues, aiming to offer a process of continuous improvement management to deliver better products and services.
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Affiliation(s)
| | | | - Álefe Saloum Cintra
- Estácio University Center of Ribeirão Preto (UniSEB), Ribeirão Preto, SP, Brazil
| | - Elton Carlos De Almeida
- Ribeirao Preto College of Nursing at University of Sao Paulo (EERP/USP), Ribeirao Preto, SP, Brazil; and Ministry of Health, Brasilia, DF, Brazil
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Huss MB, Schmitz-Valckenberg S, Finger RP, Löffler KU, Fleckenstein M, Holz FG, Pfau M. The Willingness of Patients to Participate in an Eye Donation Registry for Research. Ophthalmologica 2020; 244:179-186. [PMID: 33316801 DOI: 10.1159/000513722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/11/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION For ophthalmologic research, the systematic correlation of clinical data with data obtained from postmortem tissue donation is of great benefit. In this respect, the establishment of an eye donation registry represents a prerequisite for the acquisition of such data. METHODS A total of 300 patients were interviewed at a tertiary referral center in Germany by means of a standardized questionnaire. Binary questions were evaluated by percentage; Likert-scaled questions (1 = does apply; 5 = does not apply) were analyzed by the median and 25th (Q25) and 75th (Q75) percentiles. RESULTS The majority of patients (77.0%) would agree to donate their eyes for research purposes. When asked about reasons against an eye donation, 60.9% of all patients only stated reasons in the category "addressable" (e.g., not enough awareness of the topic). The vast majority of patients considered it appropriate for an ophthalmologist to approach them on the issue of postmortem eye donation (median 1, Q25 1, Q75 1). CONCLUSION Overall, patients had a positive attitude towards postmortem eye donation for research purposes. Importantly, reasons given against postmortem eye donation were often related to misconceptions and were potentially addressable. These results underline the fundamental willingness of ophthalmological patients in Germany to donate their eyes postmortem for research purposes.
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Affiliation(s)
- Muriel B Huss
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Steffen Schmitz-Valckenberg
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany, .,GRADE Reading Center, Bonn, Germany, .,John A. Moran Eye Center, University of Utah, Salt Lake, Utah, USA,
| | - Robert P Finger
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Karin U Löffler
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany
| | - Monika Fleckenstein
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany.,GRADE Reading Center, Bonn, Germany.,John A. Moran Eye Center, University of Utah, Salt Lake, Utah, USA
| | - Frank G Holz
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany.,GRADE Reading Center, Bonn, Germany
| | - Maximilian Pfau
- Department of Ophthalmology, University Hospital Bonn, Bonn, Germany.,GRADE Reading Center, Bonn, Germany.,Department of Biomedical Data Science, Stanford University, Stanford, California, USA
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Corneal donation for research versus for transplantation: A-year prospective study of acceptance rates in a French University Hospital. PLoS One 2020; 15:e0233392. [PMID: 32437464 PMCID: PMC7241724 DOI: 10.1371/journal.pone.0233392] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 05/04/2020] [Indexed: 11/20/2022] Open
Abstract
Fresh corneal donation is essential for basic and preclinical research, but more unknown to public and the medical teams than donation for transplantation: it may raise concerns. We prospectively compared the acceptance rates and the characteristics of targeted corneal donation for research versus donation for transplantation during one year. The Agence de la Biomédecine authorized us to procure fresh corneas targeted for research, only from the donors with medical contraindications for transplantation, in order not to increase grafts shortage. Three nurses from the hospital coordination team of Saint-Etienne University Hospital, obtained consent for research and transplantation in parallel, screening all intra-hospital deaths cases, following standard protocol to check no refusal from families, despite the French opt-out system. They contacted 127 families for research and 244 for transplantation, in 71% of cases by telephone. Consent was obtained in 62% of cases for research and 54% for transplantation (P = 0.135). The main contraindication for transplantation was the cognitive disorders (66%) followed by the blood cancers (8%). This new specific activity, providing new source of fresh corneas for research immediately usable without any eyebank storage steps, didn't reduce the number of corneas procured for transplantation versus previous years (P = 0.998). Donors in the research group were 10 years older (P<0.001) without difference regarding endothelial cell quality (P = 0.071), allowing maximal clinical relevance for protocols using these fresh human scientific corneas provided by targeted donation.
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Stamer WD, Williams AM, Pflugfelder S, Coupland SE. Accessibility to and Quality of Human Eye Tissue for Research: A Cross-Sectional Survey of ARVO Members. ACTA ACUST UNITED AC 2018; 59:4783-4792. [DOI: 10.1167/iovs.18-25319] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- W. Daniel Stamer
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, United States
| | - Andrew M. Williams
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
| | - Stephen Pflugfelder
- Department of Ophthalmology, Baylor University College of Medicine, Houston, Texas, United States
| | - Sarah E. Coupland
- Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
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Williams AM, Muir KW. Awareness and attitudes toward corneal donation: challenges and opportunities. Clin Ophthalmol 2018; 12:1049-1059. [PMID: 29922034 PMCID: PMC5995274 DOI: 10.2147/opth.s142702] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
There is a severe shortage of donor corneas available worldwide for transplantation, with the number of patients in need of transplant greatly exceeding the number of cornea tissues available. Understanding awareness and attitudes about corneal donation worldwide is a critical step toward addressing this shortage. In this review, awareness of corneal donation and reported willingness to donate are summarized from 55 published studies across 13 countries. In general, many more respondents indicated positive attitudes toward eye donation and willingness to donate their eyes than the number of respondents who have pledged their eyes for donation, suggesting an unrealized potential of additional donors. Specifically, of 38,851 respondents across all included studies, 52% endorsed a willingness to donate their eyes after death, yet only 5% reported being a pledged donor. The most commonly cited reason for not being a registered eye donor was lack of awareness about eye donation. The disconnection between the large number of people who expressed willingness to donate and the scarcity of individuals who have pledged their eyes for donation could be addressed through educational media campaigns, collaborations with medical personnel, partnerships with grief counselors and religious leaders, use of social media, and educational sessions with medical students and staff.
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Affiliation(s)
- Andrew M Williams
- Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Kelly W Muir
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
- Durham VA Medical Center, Health Services Research and Development, Durham, NC, USA
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Liu Y, Allingham RR. Major review: Molecular genetics of primary open-angle glaucoma. Exp Eye Res 2017; 160:62-84. [PMID: 28499933 DOI: 10.1016/j.exer.2017.05.002] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/29/2017] [Accepted: 05/07/2017] [Indexed: 12/13/2022]
Abstract
Glaucoma is a leading cause of irreversible blindness worldwide. Primary open-angle glaucoma (POAG), the most common type, is a complex inherited disorder that is characterized by progressive retinal ganglion cell death, optic nerve head excavation, and visual field loss. The discovery of a large, and growing, number of genetic and chromosomal loci has been shown to contribute to POAG risk, which carry implications for disease pathogenesis. Differential gene expression analyses in glaucoma-affected tissues as well as animal models of POAG are enhancing our mechanistic understanding in this common, blinding disorder. In this review we summarize recent developments in POAG genetics and molecular genetics research.
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Affiliation(s)
- Yutao Liu
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA, United States; James & Jean Culver Vision Discovery Institute, Augusta University, Augusta, GA, United States; Center for Biotechnology and Genomic Medicine, Augusta University, Augusta, GA, United States
| | - R Rand Allingham
- Department of Ophthalmology, Duke University Medical Center, Durham, NC, United States; Duke - National University of Singapore (Duke-NUS), Singapore.
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Funke S, Perumal N, Bell K, Pfeiffer N, Grus FH. The potential impact of recent insights into proteomic changes associated with glaucoma. Expert Rev Proteomics 2017; 14:311-334. [PMID: 28271721 DOI: 10.1080/14789450.2017.1298448] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
INTRODUCTION Glaucoma, a major ocular neuropathy, is still far from being understood on a molecular scale. Proteomic workflows revealed glaucoma associated alterations in different eye components. By using state-of-the-art mass spectrometric (MS) based discovery approaches large proteome datasets providing important information about glaucoma related proteins and pathways could be generated. Corresponding proteomic information could be retrieved from various ocular sample species derived from glaucoma experimental models or from original human material (e.g. optic nerve head or aqueous humor). However, particular eye tissues with the potential for understanding the disease's molecular pathomechanism remains underrepresented. Areas covered: The present review provides an overview of the analysis depth achieved for the glaucomatous eye proteome. With respect to different eye regions and biofluids, proteomics related literature was found using PubMed, Scholar and UniProtKB. Thereby, the review explores the potential of clinical proteomics for glaucoma research. Expert commentary: Proteomics will provide important contributions to understanding the molecular processes associated with glaucoma. Sensitive discovery and targeted MS approaches will assist understanding of the molecular interplay of different eye components and biofluids in glaucoma. Proteomic results will drive the comprehension of glaucoma, allowing a more stringent disease hypothesis within the coming years.
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Affiliation(s)
- Sebastian Funke
- a Experimental Ophthalmology , University Medical Center , Mainz , Germany
| | - Natarajan Perumal
- a Experimental Ophthalmology , University Medical Center , Mainz , Germany
| | - Katharina Bell
- a Experimental Ophthalmology , University Medical Center , Mainz , Germany
| | - Norbert Pfeiffer
- a Experimental Ophthalmology , University Medical Center , Mainz , Germany
| | - Franz H Grus
- a Experimental Ophthalmology , University Medical Center , Mainz , Germany
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Williams AM, Stamer WD, Allingham RR. Increasing the Availability and Quality of Donor Eyes for Research. JAMA Ophthalmol 2016; 134:351-2. [PMID: 26768017 DOI: 10.1001/jamaophthalmol.2015.5492] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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