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Report on 10 Years of Experience with Comprehensively Collecting Follow-up Data in Penetrating Keratoplasty Using a Relational Database System*

Böhringer D., Reinhard T., Sundmacher R.,
Heinrich-Heine-Universität Düsseldorf, Universitäts-Augenklinik (Düsseldorf)

Background: Influencing factors on mid- and long-term clear graft survival following penetrating keratoplasty are poorly characterized at present. Due to abundance and complex interaction of putative influencing factors, comprehensive collection of pre- and postoperative data is a prerequisite. Furthermore, quality control as addressed in the German transplantation law from 1997 is only possible when comprehensive data are available in a database system.
Methods: All data from corneas preserved at the Lions cornea bank NRW as well as donor- and follow-up data are entered into a custom relational database system. This system implements management of data concerning the waiting list, organ culture, surgical data and follow-up.
Results: Data of 1710 donors, 3333 recipients and 2753 follow-up visits have been entered into the system so far. Practically relevant evidence could already be revealed by analysis of this data. One example was the finding that post keratoplasty chronic endothelial cell loss depends on post mortem time as well as on donor age. Organ culture and organ allocation have already been modified at the Lions cornea bank NRW as a result, in order to minimize chronic endothelial cell loss in the future.
Conclusions: The database system has proven to be indispensable for scientific research and documentation. Deployment at other cornea banks is possible and should be aimed at actively due to the positive results to date. This could pave the way for future multicenter studies on penetrating keratoplasty.
*Supported by Eurotransplant/BIS Leiden (NL)