Spotlight on the Eye Bank
The Eye Bank at NNUH is manned by just two staff members who cover the whole of Norfolk.
Led by Manager Lisa Knights, they investigate deaths across the three hospitals for potential corneal donation.
During the last two years, 335 eye retrievals have been carried out which have gone on to provide 670 corneal transplants, giving other people the amazing gift of sight.
Lisa and Assistant Eye Bank Coordinator Amanda Mabey explore what brought the patient into hospital, their past medical history and the reason they have passed away. Not everyone can be considered for donation; with conditions such as blood cancers and certain neurological conditions, for example dementia, ruling them out.
It’s then a delicate job to approach a patient’s relatives and start the conversation about corneal donation.
“If the patient looks suitable from our investigations, we check the Organ Donation Register,” said Lisa. “If they have opted out of corneal donation, we do nothing further. We also obtain coroner’s permission if necessary. We then telephone the family and explain that their loved one would be suitable for potential corneal donation, asking them if that is something they knew, or think the deceased would like to do.”
With retrievals needing to be made within 24 hours of death, these phone calls can take place just four hours after a loved one has passed away, making it a very difficult conversation.
But Lisa also finds it very rewarding. “We’ve looked at the notes, we’ve looked at their history and we’ve built a picture and a story of what’s happened to them, so when we finally speak to the family we feel like we know that patient, even though we’ve never met them,” she said. “We always start the call by explaining we work alongside the Bereavement team and give them an idea of what will happen next, often answering questions. Generally, families are very appreciative of our call, whether they agree to donation or not. Sometimes I can find it emotional, especially if the death is sudden.
“We apologise for calling so soon, but usually families realise the time scales involved. We make it clear it’s their decision; we are not there to persuade them; we are there to give them the option.”
Often families will want some time to discuss the idea with other relatives and will call the Eye Bank back to confirm their wishes.
If the family would like to proceed with donation and consent is in place, the retrieval is then carried out. Lisa and Amanda are specially trained by NHS Blood and Transplant to remove the whole eye and take a blood sample which is then couriered to Bristol or Liverpool Eye Bank where the blood sample will be examined, and the cornea will be removed from the eye. Within three weeks the cornea will be sent to a hospital where a patient will have a corneal transplant.
The donor’s appearance is restored after the retrieval so that their loved ones can see them if they wish in the undertakers. Lisa added: “We always say to families their loved one will look asleep after we’ve finished, and 99% of the time you can’t tell the retrieval has taken place.”
The NNUH is unique in having a dedicated Eye Bank onsite, available seven days a week for advice and retrievals, working on call. All wards can contact Lisa or Amanda to advise them if they have a patient receiving end of life care who would be suitable for donation. Lisa urges all staff to talk to relatives about corneal donation so that we don’t disappoint patients and families who are keen to donate.
Lisa and Amanda love their job, knowing how a donor and their family can change someone else’s life. Lisa said: “To know that we’re doing a good thing and they’re going to be giving the gift of sight to other people, I think that’s amazing. Corneal transplants would not take place if it wasn’t for the generosity of families at a very difficult time.”