Quality Indicators For The Processing And Use Of Sclera For Transplantation In Brazil: An Ecological Study

Le résumé fourni par la source

Introduction: The scarcity of ocular tissues available for transplantation still represents a challenge for the Brazilian National Transplant System. The sclera has clinical importance in reconstructive surgeries, and its procurement, preservation, and distribution depend on the efficiency of Human Eye Tissue Banks. The analysis of quality indicators allows for the identification of weaknesses and guides strategies for optimizing therapeutic use. Objective: To generate quality indicators for analyzing the processing and use of sclera for transplantation in Brazil. Method: A quantitative, ecological, descriptive, observational study based on the Brazilian Production Report of Human Eye Tissue Banks from the National Health Surveillance Agency. Forty-six Human Eye Tissue Banks distributed across the five Brazilian regions were included. The values were relative per million population and calculated using five indicators: utilization rate of preserved sclera, disqualification rate, therapeutic use rate, transplant rate relative to the total preserved tissue, and overall efficiency index. Regional comparisons were performed using the Kruskal-Wallis test, the Dwass-Steel-Critchlow-Fligner post-hoc test, and the epsilon squared test to assess the magnitude of the differences found, all with a significance level of 0.05. Results: Human Eye Tissue Banks preserved 2,741 sclerae in one year, mainly concentrated in the Southeast (33.4%) and South (24.4%) regions. The national disqualification rate was 23.5%, ranging from 11.6% in the Central-West to 66.1% in the North (p<0.01). The utilization rate was higher in the South (94.5%) and lower in the North (26.6%), while the therapeutic use rate stood out in the Southeast (61.8%) and South (57.9%). The transplantation rate as a percentage of the total preserved tissue reached 74.9% in the Southeast and 76.5% in the Midwest, in contrast to 32.9% in the Northeast. The overall efficiency index ranged from 40.0% (Northeast) to 90.0% (Midwest), highlighting significant regional inequality. Conclusion: Regional inequalities were observed in the production and utilization of scleral tissue, with better performance in the Midwest, Southeast, and South regions. The North and Northeast presented operational and structural weaknesses. The findings reinforce the need for process standardization, team training, and strengthening of the national network to expand the availability and therapeutic use of scleral tissue.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.