Barriers to ocular tissue donation in acute clinical settings

Introduction: Nearly all patients who die in Intensive Care Units (ICU’s) and Emergency Departments (ED’s) are potential corneal donors. However, the number of referrals from these groups remains low.Purpose: To identify the number of potential corneal donors in four ICUs and one ED and to ascertain how many proceed with donation.Materials and methods: The electronic medical records of all patients (n=233) who died in the five participating units from July to December 2014 were retrospectively reviewed using existing ocular tissue donor criteria to assess the number of potential donors. The Eye Donor Database and the Potential Donor Audit were also reviewed to determine how many potential corneal donors proceeded with donation. Results: Out of the 73% (n=170) eligible cornealdonors, 79% (n=100) were potential tissue-only donors and 21% (n=36) had the potential to donate solid organs and at least one tissue (corneas). While all 36 potential organ and tissue donors were referred to the Specialist Nurse in Organ Donation (SN-OD), none of the 100 potential tissue-only was referred to Tissue Services. Of the 36 potential organ and tissue donors referred to the SN-OD, only 11 proceeded with corneal donation.Conclusion: The results of this audit highlight a low conversion rate from a relatively high number of potential corneal donors. There is a need to increase corneal donation awareness among healthcare professionals and the public. It is also recommended the implementation of strategies to maximise the number of referrals.