{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:26:43Z","timestamp":1775024803925,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Purpose: (1) To determine the prevalence of herpes simplex virus type 1 (HSV-1) and type 2 (HSV-2), varicella-zoster virus (VZV), and cytomegalovirus (CMV) DNA in donor corneas; (2) To evaluate the clinical outcome of the grafts with viral DNA and to compare donors with and without viral DNA. Methods: We analyzed data from all donors and recipients who underwent penetrating keratoplasty (PK) or Descemet membrane endothelial keratoplasty (DMEK) between September 2022 and March 2023. Donor corneoscleral rims and excised recipients\u2019 corneal buttons were tested for the presence of HSV-1, HSV-2, VZV, and CMV DNA by polymerase chain reaction (PCR). The results were known 2\u20133 days after the surgery. We closely followed up on patients whose grafts tested positive for viral DNA. We compared the medical histories of donors with and without viral DNA. Results: We included 85 corneas from 67 donors. Seven (8.2%) donor corneas tested positive for HSV-1 (n = 3) or VZV (n = 4) DNA. We did not detect any HSV-2 or CMV DNA. In the postoperative follow-up of patients with positive PCR, a graft failure was observed in one and infections in two eyes. Re-operation was necessary in three of these cases (42.9%). Patients without herpes DNA in the donor cornea needed reoperation in 7.7% of the cases. Cultural duration, the cause of the donor\u2019s death, and the death-to-explantation interval did not differ significantly between donors with and without viral DNA. Additionally, 3 of the 7 (42.9%) donors with positive PCR were in a septic status at the time of death, compared to 21 of the 78 (26.9%) donors with negative PCR (p = 0.52). Conclusions: The prevalence of herpes DNA in the donor corneas was 8.2% and thus higher than previously reported. We did not notice any evidence for a donor-to-host transmission, but a higher rate of postoperative complications in recipients of the grafts with viral DNA. The donors with and without herpetic DNA did not differ significantly regarding systemic diagnoses or cultural conditions, but sepsis was more frequent in the group with viral DNA.<\/jats:p>","DOI":"10.3390\/microorganisms11102405","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T03:04:18Z","timestamp":1695783858000},"page":"2405","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Prevalence of Herpes Simplex and Varicella-Zoster Virus DNA in Corneal Grafts Is Higher than Expected"],"prefix":"10.3390","volume":"11","author":[{"given":"Marie Ella","family":"Horstmann","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Al Hariri","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie D.","family":"Grabitz","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4992-5787","authenticated-orcid":false,"given":"Julia Bing","family":"Bu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Apel","sequence":"additional","affiliation":[{"name":"Eye Bank of Rhineland-Palatinate in Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norbert","family":"Pfeiffer","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7025-8280","authenticated-orcid":false,"given":"Joanna","family":"Wasielica-Poslednik","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,26]]},"reference":[{"key":"ref_1","unstructured":"Hunter, L. (2022). Diagnosis and Treatment of Herpes Keratitis. Rev. Ophthalmol. November, 29\u201335."},{"key":"ref_2","unstructured":"Rausch, A. (2023). Update Herpes Zoster, CME-Verlag GmbH."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.preteyeres.2012.08.002","article-title":"Herpes keratitis","volume":"32","author":"Rowe","year":"2013","journal-title":"Prog. Retin. Eye Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/ICU.0000000000000618","article-title":"Ocular manifestations of herpes simplex virus","volume":"30","author":"Valerio","year":"2019","journal-title":"Curr. Opin. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1136\/bjophthalmol-2012-302294","article-title":"Optical aberrations in patients with recurrent herpes simplex keratitis and apparently normal vision","volume":"97","author":"Kaswin","year":"2013","journal-title":"Br. J. Ophthalmol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1097\/01.ico.0000138841.44926.f8","article-title":"Opinions on Risk Factors and Management of Corneal Graft Rejection in the United Kingdom","volume":"24","author":"Koay","year":"2005","journal-title":"Cornea"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1001\/archopht.117.4.445","article-title":"Oral acyclovir after penetrating keratoplasty for herpes simplex keratitis","volume":"117","author":"Tambasco","year":"1999","journal-title":"Arch. Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bu, J.B., Grabitz, S.D., Pfeiffer, N., and Wasielica-Poslednik, J. (2022). Prevalence of Herpesvirus DNA in Corneal Transplant Recipients. J. Clin. Med., 12.","DOI":"10.3390\/jcm12010289"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00347-008-1913-x","article-title":"Procedural guidelines. Good tissue practice for cornea banks","volume":"106","author":"Schroeter","year":"2009","journal-title":"Ophthalmologe"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1002\/jmv.24675","article-title":"Occurrence of viral DNA in paired samples of corneal rim and cornea preservation fluid","volume":"89","author":"Broniek","year":"2016","journal-title":"J. Med. Virol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1086\/599329","article-title":"Prevalence and Clinical Consequences of Herpes Simplex Virus Type 1 DNA in Human Cornea Tissues","volume":"200","author":"Remeijer","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1016\/S0140-6736(00)04011-3","article-title":"Herpes simplex virus 1 transmission through corneal transplantation","volume":"357","author":"Remeijer","year":"2001","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/S0002-9394(14)72384-0","article-title":"Herpes Simplex Dendritic Keratitis After Keratoplasty","volume":"111","author":"Mannis","year":"1991","journal-title":"Am. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1097\/00003226-200403000-00003","article-title":"Culture-Proven Herpetic Keratitis After Penetrating Keratoplasty in Patients with No Previous History of Herpes Disease","volume":"23","author":"Borderie","year":"2004","journal-title":"Cornea"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2767","DOI":"10.1007\/s00417-020-04984-2","article-title":"The incidence and influence of the donor corneas positive for herpesviridae DNA in keratoplasty","volume":"258","author":"Qu","year":"2020","journal-title":"Graefe\u2019s Arch. Clin. Exp. Ophthalmol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1097\/ICO.0b013e31802eaee6","article-title":"Corneal Buttons Obtained from Patients with HSK Harbor High Copy Numbers of the HSV Genome","volume":"26","author":"Shimomura","year":"2007","journal-title":"Cornea"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1136\/bjo.84.7.701","article-title":"Graft failure in human donor corneas due to transmission of herpes simplex virus","volume":"84","author":"Biswas","year":"2000","journal-title":"Br. J. Ophthalmol."},{"key":"ref_18","first-page":"1847","article-title":"Tissue-specific accumulation of latency-associated transcripts in herpes virus-infected rabbits","volume":"39","author":"Tsao","year":"1998","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1016\/S0140-6736(00)04638-9","article-title":"Herpes simplex virus infections","volume":"357","author":"Whitley","year":"2001","journal-title":"Lancet"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2651","DOI":"10.1128\/JVI.79.5.2651-2658.2005","article-title":"Varicella-Zoster Virus Pathogenesis and Immunobiology: New Concepts Emerging from Investigations with the SCIDhu Mouse Model","volume":"79","author":"Ku","year":"2005","journal-title":"J. Virol."},{"key":"ref_21","first-page":"e77","article-title":"Herpes simplex virus PCR in 2230 explanted corneal buttons","volume":"100","author":"Seitz","year":"2021","journal-title":"Acta Ophthalmol."},{"key":"ref_22","unstructured":"(2023, May 18). Deutsche Gesellschaft f\u00fcr Gewebetransplantation\u2014Gemeinn\u00fctzige Gesellschaft mbH Home Page. Available online: https:\/\/gewebenetzwerk.de\/voraussetzungen-gewebespende\/."}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/10\/2405\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:58:59Z","timestamp":1760129939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/11\/10\/2405"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,26]]},"references-count":22,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["microorganisms11102405"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms11102405","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,26]]}}}