Shortage of donors deprives children of blindness cure

Health Editor,Jeremy Laurance
Monday 29 November 2004 01:00 GMT
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Babies born with eye disorders are at risk of permanent blindness because of a shortage of donors for transplant operations.

Babies born with eye disorders are at risk of permanent blindness because of a shortage of donors for transplant operations.

A surgical technique developed within the last decade has brought the promise of a cure to children who faced a lifetime of blindness. But now it is threatened by a lack of donors.

Ken Nischal, consultant ophthalmologist at Great Ormond Street Hospital for Children, was forced to appeal yesterday for donors to help six children aged from 11 months to 13 years waiting for new corneas - the transparent covering at the front of the eyeball.

The appeal is urgent because the developing brain has to learn to see and it cannot do so without visual stimulus from the eyes. Even a delay of a few months can leave a permanent deficit. "The longer the wait, the greater the visual deficit," said Mr Nischal. "I have one baby aged nine months old who has been waiting five months. That is more than half his lifetime."

Mr Nischal, who has pioneered cornea transplants in babies and young children in Britain, said the availability of donors had fallen since the Alder Hey scandal in 2001, when it emerged that the bodies of dead children had been stripped of their organs and stored at Alder Hey hospital, Liverpool, without the consent of parents. "We do think Alder Hey has made the situation worse," he said. "There has been a definite fall off in the availability of organs from donors at a younger age."

Among the children whose sight is at risk is Harry Gurney-Randall, now aged two, whose eyes were cloudy at birth. Transplants were performed on both eyes before he was 16 weeks old but they were rejected by his body. His mother, a 42-year-old manager at the British Medical Journal, said: "Now he will need two new grafts. We have tried to get a match [which is necessary for second attempts] but because there are not enough donors available we can't afford the time. It is desperate. The days are ticking past. It is very difficult to deal with that."

A donor has been found for one eye and an operation is scheduled for December, but a second donor has yet to be found.

Corneal transplant is routine in adults but a high risk procedure in children. The eyeball is in danger of collapse and the operation calls for a high degree of surgical and anaesthetic skill. Children also run a higher risk of rejection, in which the new cornea turns cloudy, and require frequent monitoring in the early weeks.

Until 10 years ago, doctors were taught that nothing could be done for children who suffered from eye conditions such as Peter's Anomaly and sclerocornea. Mr Nischal learnt the new technique during a spell working with surgeons in Toronto, Canada, in 1997 and now runs the main centre for the surgery in the UK at Great Ormond Street.

Over six years he has treated more than 50 children, of whom 36 have received transplants. Donors must be aged over two and under 22. Corneas taken from infants who have died and older adults can cause problems with rejection.

"Finding donors is really difficult. People don't consider that children may need a corneal graft," Mr Nischal said.

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