Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population

Gabriel M. Rand, Daniel J. Polla, Sejal H. Patel, Patrick K. Gore, Lynn Forest-Smith, Tina M. Livesay, Roy S. Chuck

Research output: Contribution to journalArticle

Abstract

PURPOSE: To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. METHODS: Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. RESULTS: One thousand six hundred eighty-four (32.1%) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). CONCLUSIONS: DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.

Original languageEnglish (US)
Pages (from-to)1203-1208
Number of pages6
JournalCornea
Volume38
Issue number10
DOIs
StatePublished - Oct 1 2019

Fingerprint

Eye Banks
Diabetes Mellitus
Tissue Donors
Transplants
Endothelial Cells
Cell Count
Population
Type 1 Diabetes Mellitus
Lenses
Type 2 Diabetes Mellitus
Pseudophakia
Refrigeration
Cell Communication
Endothelium

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Rand, G. M., Polla, D. J., Patel, S. H., Gore, P. K., Forest-Smith, L., Livesay, T. M., & Chuck, R. S. (2019). Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population. Cornea, 38(10), 1203-1208. https://doi.org/10.1097/ICO.0000000000002047

Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population. / Rand, Gabriel M.; Polla, Daniel J.; Patel, Sejal H.; Gore, Patrick K.; Forest-Smith, Lynn; Livesay, Tina M.; Chuck, Roy S.

In: Cornea, Vol. 38, No. 10, 01.10.2019, p. 1203-1208.

Research output: Contribution to journalArticle

Rand, GM, Polla, DJ, Patel, SH, Gore, PK, Forest-Smith, L, Livesay, TM & Chuck, RS 2019, 'Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population', Cornea, vol. 38, no. 10, pp. 1203-1208. https://doi.org/10.1097/ICO.0000000000002047
Rand GM, Polla DJ, Patel SH, Gore PK, Forest-Smith L, Livesay TM et al. Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population. Cornea. 2019 Oct 1;38(10):1203-1208. https://doi.org/10.1097/ICO.0000000000002047
Rand, Gabriel M. ; Polla, Daniel J. ; Patel, Sejal H. ; Gore, Patrick K. ; Forest-Smith, Lynn ; Livesay, Tina M. ; Chuck, Roy S. / Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population. In: Cornea. 2019 ; Vol. 38, No. 10. pp. 1203-1208.
@article{45e01549d3cc4490accd33ac637618ee,
title = "Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population",
abstract = "PURPOSE: To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. METHODS: Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. RESULTS: One thousand six hundred eighty-four (32.1{\%}) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). CONCLUSIONS: DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.",
author = "Rand, {Gabriel M.} and Polla, {Daniel J.} and Patel, {Sejal H.} and Gore, {Patrick K.} and Lynn Forest-Smith and Livesay, {Tina M.} and Chuck, {Roy S.}",
year = "2019",
month = "10",
day = "1",
doi = "10.1097/ICO.0000000000002047",
language = "English (US)",
volume = "38",
pages = "1203--1208",
journal = "Cornea",
issn = "0277-3740",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Donor Diabetes Mellitus Severity and Corneal Transplant Suitability in a US Eye Bank Donor Population

AU - Rand, Gabriel M.

AU - Polla, Daniel J.

AU - Patel, Sejal H.

AU - Gore, Patrick K.

AU - Forest-Smith, Lynn

AU - Livesay, Tina M.

AU - Chuck, Roy S.

PY - 2019/10/1

Y1 - 2019/10/1

N2 - PURPOSE: To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. METHODS: Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. RESULTS: One thousand six hundred eighty-four (32.1%) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). CONCLUSIONS: DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.

AB - PURPOSE: To determine whether donor diabetes mellitus (DM) severity is associated with differences in endothelial cell density (ECD) and surgically unsuitable tissue. METHODS: Raw data were obtained from Saving Sight Eye Bank (Kansas City, MO) including 10,454 donated eyes from 5346 eligible donors from July 2014 through May 2017. Donors were grouped into 5 categories by their insulin use and the presence of microvascular end-organ complications. The categories were non-DM (NDM), noninsulin-dependent DM without complications (NIDDMnc), noninsulin-dependent DM with complication (NIDDMc), insulin-dependent DM without complications, and insulin-dependent DM with complication. Outcome variables included ECD and tissue transplant suitability. Mixed effects models were used to adjust for the random effect of repeated measures and fixed effects of donor age, race, lens status, and death to refrigeration and death to preservation times. Interaction effects of DM severity group and donor age and DM severity group and lens status were included in the models. RESULTS: One thousand six hundred eighty-four (32.1%) donors had a diagnosis of DM. Six hundred fifty-eight donors were in the NIDDMnc group, 225 in the NIDDMc group, 404 in the insulin-dependent DM without complication group, and 397 in the insulin-dependent DM with complication group. Compared with non-DM, donors with DM were older (P < 0.001) and more likely to be pseudophakic (P < 0.001). DM severity groups did not affect adjusted ECD at mean donor age. There was no statistically significant ECD interaction between DM severity group and lens status. There was a statistically significant ECD crossover interaction with NIDDMnc and donor age (P < 0.001). In phakic eyes, NIDDMc was associated with a statistically significantly lower odds of transplant suitability (odds ratio 0.62, P = 0.006). CONCLUSIONS: DM severity does not affect lowering adjusted ECD at mean donor age. DM severity and pseudophakia were not associated with lower adjusted ECD. NIDDMnc was associated with an attenuation of the age-dependent decrease in ECD. NIDDMc was associated with decreased transplant suitability in phakic eyes. Future studies should include age, lens status, and interaction effects in their models of ECD and transplant suitability.

UR - http://www.scopus.com/inward/record.url?scp=85071898645&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85071898645&partnerID=8YFLogxK

U2 - 10.1097/ICO.0000000000002047

DO - 10.1097/ICO.0000000000002047

M3 - Article

VL - 38

SP - 1203

EP - 1208

JO - Cornea

JF - Cornea

SN - 0277-3740

IS - 10

ER -