Impact of Donor Age on Eligibility for Corneal Tissue Donation and Transplantation Suitability: A 2-Year Retrospective Analysis of Donors Aged up to 89 years

Purpose: To assess how donor age affects eligibility for corneal tissue donation, consent patterns, tissue quality, and utilization rate. Materials and Methods: This retrospective study included deceased individuals aged 16 to 89 years who were assessed for corneal donation eligibility at the University Hospitals of Geneva between January 2023 and December 2024. Donor age was analyzed in relation to eligibility and consent for donation. The effects of age and the history of cataract surgery on endothelial cell density (ECD) and on the suitability of retrieved corneas for transplantation were also evaluated. Results: Of 2553 potential tissue donors screened (median age 78 years), 430 (16.8%) were eligible for donation. Eligibility rates decreased significantly with age (23.5% for <60 years, 20.7% for 60–75 years, 13.4% for 76–89 years; P < 0.001). However, 46% of eligible donors were older than 75 years. Consent for donation increased slightly with age. Among 370 procured corneas (mean donor age 72.6 ± 13.1 years), 81.1% were suitable for transplantation. Donor age was not significantly associated with transplantation suitability ( P = 0.721). ECD decreased significantly with age (−8.6 cells/yr, P < 0.001), being higher in individuals younger than 60 years, with only small variations among older age groups. Conclusions: Although donor age significantly decreases eligibility rates and ECD values, it does not compromise the suitability of recovered corneas for transplantation. Nearly half of eligible donors were older than 75 years, highlighting the potential of aged donors to contribute to addressing the corneal graft shortage issue, provided that optimized donor selection criteria are applied.