Organ culture: the method of choice for preservation of human donor corneas

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Abstract
In hypothermic storage corneas are preserved at 4°C in tissue culture medium supplemented with antibiotics and with dehydrating agents (dextran, chondroitin sulphate) to prevent corneal swelling. The original M-K medium4 5 has been succeeded by solutions such as K-sol, Dexsol, and Likorol potentially allowing a storage time exceeding the 4 days thought to be the maximum for the M-K medium. In organ culture preservation corneas are incubated in tissue culture medium supplemented with fetal calf serum, antibiotics, and antimycotics at 30–37°C. The swelling of the cornea, due to the absence of dehydrating agents in the medium, is reversed shortly before transplantation by placing the cornea, in the first instance, in M-K medium at 4°C.9 Currently the swelling is reversed by transferring the corneas to a culture medium supplemented with dextran (4–8%) at room temperature to 37°C. Because the integrity of the endothelium is better maintained during organ culture6 7 10 the storage time of 4 to 5 weeks allowed by organ culture is long compared with the generally accepted period of 3 to 5 days for hypothermic storage. The actual storage time limit for the 4°C preservation, however, is not known. Hypothermic storage has been accepted by many eye banks all over the world, while organ culture, strongly promoted by the Eye Bank of Arhus, became the method of choice for eye banks in Europe.