Work

6 Ocular tissue donor selection: improving efficiency through the implementation of an «Upstream» approach

Year: 2026

Type: conference-paper

Abstract: Introduction The safety and effectiveness of corneal transplantation largely depend on rigorous donor selection based on clinical eligibility criteria and tissue quality. Donor evaluation involves an integrated assessment of me-dical history, serological testing for transmissible infections, and morphological examination of the cornea, all of which are essential to ensure recipient safety. The donor selection process directly impacts the avai-lability of donated tissues, both in terms of suitability and readiness for processing in response to trans-plant demands. While maintaining high standards of safety and quality, the Donation Medicine team of the Veneto Eye Bank Foundation (FBOV) modified its donor selection strategy by shifting from a ‘downstream’ approach to an ‘upstream’ approach. This change aimed to reduce the average donor selection time, a critical factor for the timely processing of tissues from donors already deemed suitable for transplantation (e.g., EK, DMEK), as well as for logistics and surgical scheduling.Materials and Methods Donors from 2023 through November 30, 2025 were analyzed (3,394; 3,590; and 3,196 donors, respec-tively), with particular focus on donors selected during the same years (2,853; 2,897; and 2,726, respec-tively). Specific attention was given to the average donor selection time and the timely identification of non-eligible donors. The comparison focused on the downstream approach used during the first eight months of 2025 versus the upstream approach adopted from September onward (September–November) of the same year.Results In 2023, the mean donor selection time was 11 days (SD 2.0), decreasing to 10 days in 2024 (SD 1.8) and to 9.5 days in 2025 (SD 1.3). Focusing on 2025 alone, the mean donor selection time was 10.1 days during the first eight months of the year (SD 0.95) and 7.6 days (SD 0.55) during the September–November period.Expected Impact and Conclusions The shift to an upstream donor selection approach resulted in a substantial reduction in the average do-nor selection time. This change alleviated workload pressure on the Donation Medicine team, a critical area for tissue intake and distribution, allowing analysts to optimize selection time and focus resources on more complex donor evaluations. Consequently, the entire eye banking process, from tissue processing to transplant scheduling, benefited from the experimental implementation of the upstream donor selection approach.

Source: BMJ Open Ophthalmology

DOI: 10.1136/bmjophth-2026-eeba.6