The incidence and influence of the donor corneas positive for herpesviridae DNA in keratoplasty
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CORNEA
The incidence and influence of the donor corneas positive for herpesviridae DNA in keratoplasty Jing-hao Qu 1,2 & Rong-mei Peng 1,2 & Ge-ge Xiao 1,2 & Hong-qiang Qu 1,2 & Ting Yu 1,2 & Shuang Zhang 1,2 & Jing Hong 1,2 Received: 20 July 2020 / Revised: 11 October 2020 / Accepted: 15 October 2020 # The Author(s) 2020
Abstract Purpose We detected the DNA of herpes simplex virus type 1 (HSV-1), herpes simplex virus type 2 (HSV-2), varicella-zoster virus (VZV), cytomegalovirus (CMV), and Epstein-Barr virus (EBV) in donor corneas and assessed the clinical outcomes of recipients who received virus-positive grafts. Method All donor corneas were analyzed for the presence of HSV-1, HSV-2, VZV, CMV, and EBV by real-time PCR from April 2017 to July 2019. The medical records of the transplant patients who received virus-positive grafts were reviewed. Result Twenty-three (2.44%) donor cornea buttons tested positive for herpesviridae DNA. The positivity rates of HSV-1, CMV, VZV, and EBV were 0.74%, 0.85%, 0.64%, and 0.21%, respectively. Conclusion We suggest that the corneas from donors who had cancer, donors who were inpatients, and donors who had immunodeficiency or who were on immunosuppressive therapy should be tested for herpesviridae DNA before transplantation. Finally, HSV-1 can be transmitted from graft to recipient, but that CMV cannot be transmitted according to our observations. The donor corneas found to be HSV-1-positive have to be discarded and not used for keratoplasty.
Key messages Herpesviridae DNA testing in donor corneas is mainly focused on HSV, and has a small sample size. Herpesviridae DNA testing in donor corneas is performed rarely, and the herpesviridae DNA positivity rate among Chinese donors is unknown. This was the largest donor cornea sample number to undergo herpesviridae DNA (HSV-1, HSV-2, CMV, VZV and EBV) detection among published research, and there are no previous reports on the total virus positivity rate. According to our study, we suggest that corneas from donors who had cancer, donors who were inpatients, and donors who had immunodeficiency or who were on immunosuppressive therapy should be tested for herpesviridae DNA before transplantation.
Keywords Donor cornea . HSV-1 . HSV-2 . VZV . CMV . EBV . Transplantation . RT-PCR
* Jing Hong [email protected] 1
Department of Ophthalmology, Peking University Third Hospital, Beijing, China
2
Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
Graefes Arch Clin Exp Ophthalmol
Introduction The cornea is composed of avascular tissue, making cornea transplantation the most successful human tissue transplantation procedure. With improvements in science and technology, including updated eye banking procedures, operating techniques, immunosuppressive, and antiviral drugs [1], the success rate of total corneal transplantation is more than 90% at 1 year and 70% at 5 years [2]. In recent years, researchers have implicated a formerly unknown cause of corneal graft edema, herpes
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