Serological viral testing of cadaveric cornea donors

Background. Cornea graft recipients are exposed to viral transmission from the donor. Cadaveric donor serum is often of poor quality and frequently yields falsely positive results in serological assays that may result in the graft being needlessly discarded. Objective. We examined the influence of the time of blood collection after death, and the macroscopic aspect of serum, on serological test results in cadaveric cornea donors. Methods. Five hundred sixty-five consecutive cadaveric cornea donors were systematically tested for serological markers of human immunodeficiency virus type I and 2, human T-cell leukemia virus type 1, hepatitis B and hepatitis C viruses (HCV). We studied the influence of the macroscopic aspect of the donor's serum and the time of blood collection after death on the results of serological testing and on the subsequent decision to use or discard the graft. Results. Twenty-one and a half percent of corneas were rejected on the basis of virological test results. We found significant relationships between the macroscopic aspect of serum at the time of testing and: (i) a positive, equivocal or discrepant result of immunoassays, for all markers except anti-HCV antibodies, (ii) non acceptance of cornea grafts, and (iii) the time of blood sampling after death. Conclusions. The macroscopic aspect of postmortem blood samples is the best predictor of the specificity of serological testing in cornea donors. Serological results should be interpreted with care when serum is macroscopically abnormal, and cadaveric donors should not be sampled more than 12 hr after death.