Barriers to corneal donation in hospital and medical communities

¶ … Corneal Donation within Hospitals and Medical Communities: Issues Surrounding Post Mortem Donations of Tissue

Qualitative Study

The purpose of this study is to identify barriers to corneal donation within hospitals and medical communities. A large body of research has focused on issues surrounding the post mortem donations of tissue. This research will take a different approach, examining what barriers exist within hospital and medical communities in an attempt to determine how these barriers may be overcome.

The number of potential corneal donors far surpasses the number of people available for traditional organ donations and in some states consent of the medical examiner alone is enough to allow use of corneal donations (family consent not required) (Lewin, 2000).

Traditionally the most significant barrier to organ donation and transplantation has been acquisition of organs and tissues (Murray et. al, 2002). The need for cornea tissue is rising. The average wait time for a corneal transplant is two or more years (Murray et. al, 2002). Typically patients with pain resulting from corneal disease and blindness in both eyes are considered priority patients (Murray, et. al, 2002). Thought there have been more corneas available, the wait time and list still remains long.

Significance of Research

Corneal Transplants qualify as cadaveric transplants, or organs donated from individuals clinically classified as dead (Lewin, 2000). There are many "taboos" surrounding such transplantations (Lewin, 2000), but these are usually significant only in the realm of the public. This attempts to contribute new research to the medical field by identifying the barriers that exist outside of the public realm, within hospitals and communities..

I am a Malaysian citizen, affiliated with Monash University, Malaysia. I am applying to undertake a research stint at the Corneal Eye Bank, Centre of Eye

Research Australia, located at the Department of Ophthalmology, University of Melbourne. As such my proposed area of study is transplantation of cultured corneal limbal stem cells.

The goal of this study is to undertake research abroad, in order to better understand what barriers exist to corneal donation within hospital and medical communities the world over.

The benefits of this programme of study are many. Reduce limitations on organ transplantation and tissue donation could potentially improve the quality of lives of thousands of people annually. At present research suggests the wait time for donation is greater than 2 years. Identifying and subsequently proposing solutions to the barriers that currently exist to donation will not only improve the quality of life for patients, but also help strengthen bilateral ties between Australia and Malaysia as well as strengthen Australian education and research relations with Malaysia.

Methods

The aim of this study is to discover barriers to corneal transplantation and donation from an administrative perspective. Thus the researcher proposes examination of donor registries and informed consent, as well as hospital policies, practices and procedures. A purely experimental study would not be feasible in this instance, as it would be virtually impossible in the short amount of time allocated to survey the number of people necessary to provide quantitative information on corneal donations. A qualitative study provides information relevant to exploratory processes, thus this type of technique will be utilized for purposes of this study.

The researcher intends to conduct research over a 6-month time frame. The first 1-2 months will be spent gathering adequate information from academic studies and journals to create the literature basis for the full study. The next 2 months will be spent developing and gathering responses for the interviews. The researcher will interview individuals from 4 major hospitals in the Australian and Malaysian areas. Next the researcher proposes examining and drawing logical conclusions from the data to form a hypothesis that will:

Identify barriers that exist to corneal donation in medical communities.

Propose avenues for further research and proposals for overcoming these barriers.

A search will be conducted informed consent and staff education regarding corneal donations through interviews and via sources available via the World Wide Web as well as information available from hospital and medical databases where feasible. Interviews will be conducted of hospital administrators and staff within Malaysia and Australia to assess the barriers perceived within these communities to corneal donation. These results will be compared with the literature review. The researcher will search for correlations between the results acquired through interviews and the literature review. The researcher will contact the Lions Corneal Donation Service a joint venture between the University of Melbourne and the Royal Victorian Eye and Ear Hospital to identify eye banking resources and potential hospitals for corneal donation interviews. Proposed hospitals/eye banks include: Lions NSW Eye Bank, Queensland Eye Bank and the WA Lions Eye Institute if feasible.