Choosing to be an eye, organ and tissue donor is a personal decision. Colorado and Wyoming have both adopted the Uniform Anatomical Gift Act, allowing individuals to make an anatomical gift, or donation of their body after death.
Yes, in our region of Colorado and Wyoming, the black heart symbol with a ‘Y’ inside on a driver license or state ID indicates that the person is a registered eye, organ, and tissue donor.
Eye tissue donation usually only occurs after a person has died. In very rare cases, if it is necessary that a person has their eye removed for other medical reasons, it may be possible for them to donate the eye tissue afterward.
There are other types of donation that can happen while a person is alive called living donation. Living donation is choosing to donate an organ or part of an organ while you are alive; for example donating a kidney. Living donation is facilitated by transplant centers. Learn more about living donation by visiting the United Network of Organ Sharing (UNOS).
In most cases, a highly trained technician will surgically recover the corneal tissues only (one per eye), as the corneas are the most needed tissues for transplant surgeries. The cornea is the clear tissue on the front part of the eye, about the size of a contact lens, and is responsible for 75 percent of the focusing power of the eye. On occasion, the technician will recover the whole eye if it is needed and consented for research or training, or if the scleral tissue is needed for patch grafts.
It will not be visually noticeable that the person was an eye donor during an open casket viewing at a funeral. After the surgical recovery is complete, the eye bank technician inserts small caps under the eye lids, to preserve the natural closed eye shape. This occurs prior to the embalming process. These small caps are commonly used by funeral home practitioners when preparing a decedent for viewing, whether or not the deceased was an eye tissue donor.
When a cornea tissue exhibits a heavy amount of cell loss, it may be deemed not suitable for transplant. The cause of cell loss varies, based on:
- donor characteristics,
- past medical / social history (for example, see research RMLEB previously worked on: Alcohol Abuse is Associated with Alterations in Endothelial Cell Morphology) or visit our ongoing Research Publications
- what occurred during the death process (for example, trauma to the face/eyes),
among many other variables.
Cornea surgical recovery takes a lot of skill, and RMLEB continues to try to find ways to maximize the gift and improve processes, no matter the situation. We use the term ‘technician error’ internally for staff human-related mistakes or errors associated with processes or activities we have control over, which could affect the outcome of the donation.
While these types of human error are relatively rare, unfortunately they can occur. If they do, as a conservative safety measure, we may not be able to approve the donated eye tissue for transplant. As with all errors or issues, we assess the specific situation, evaluate what happened, identify what we could have done differently, and train our staff to help prevent recurrence.
Due to time limits associated with preservation and the greatest potential for cell viability, the sooner the cornea is placed in preservation media, the better chance for a successful outcome. Because of this, when working with grieving families, funeral home schedules, and other logistics, sometimes the recovery occurs prior to obtaining all the final medical information.
In these cases, we have enough information to qualify the donor for recovery but may not have enough of the information to fully determine if the donor will be eligible for transplant or research until after we have recovered the corneas. In those situations, sometimes we receive additional information after recovery that may rule the donor out for transplant use. The tissue may still be able to be used for research purposes if the family has consented for that purpose as an option.
Eye banks, like RMLEB that are accredited by the Eye Bank Association of America (EBAA) and regulated by the US Food and Drug Administration (FDA) have in place stringent and very specific donor ID and consent verification procedures that must be followed.
All errors or issues that meet the required severity or potential risk as defined by EBAA or FDA are reported.
Anyone can register as an eye, organ, and tissue donor in the United States.
Current FDA regulations require that donated tissue (including cornea tissue) is not suitable for transplant if the donor was a man who has had sex with another man in the past five years. These requirements are different for blood and organ donation; blood donation allows for three months (compared with five years for tissue and eye tissue), and the organ donation requirement was further reduced from one year to the past 30 days.
The Eye Bank Association of America is supportive of reducing the restrictions on donated eye tissue to better align with blood and organ donation limits – particularly as corneal tissue is avascular, meaning there is no direct blood supply to a normal healthy cornea, therefore potentially limiting some possible risks associated with bloodborne related transmissions. Also, blood type does not need to match for the donor eye tissue to be safely transplanted in a recipient.
Some eye tissue donor families and eye tissue transplant recipients find comfort in writing letters ; however, the decision to write letters is a personal one. Families often find great comfort in knowing a little about the person their loved one was able to help.
RMLEB will act as the facilitator, exchanging letters between both parties. On occasion, eye tissue donor families and eye tissue transplant recipients may wish to meet each other. Both must agree to this before any personal information is released by RMLEB.