HLEB Overview

Heartland Lions Eye Banks

The main purpose of Heartland Lions Eye Banks (HLEB) is to retrieve, process and distribute the highest quality donor eye tissue to corneal surgeons and vision researchers. Currently, Heartland Lions Eye Banks is composed of six branches in three states: the three branches of the Missouri Lions Eye Bank in Columbia, Springfield, and St. Louis; the Central Illinois Lions Eye Bank in Springfield, Illinois; and the two branches of the Kansas Lions Eye Banks in Kansas City, Missouri and Hays, Kansas. All of these eye bank branches are owned and operated by the Missouri Lions Eye Research Foundation. Each branch depends heavily on the support of the Lions, as the system works together to "give the gift of sight" to those in need.

The headquarters for Heartland Lions Eye Banks is in Columbia. The Columbia staff of the HLEB distribute the donated eye tissue received by the Columbia laboratory, as well as the eye tissue retrieved and processed by the satellite eye bank branches. All Heartland Lions Eye Banks tissue is pooled in this manner to improve efficiency. The centralized distribution system allows for maximum flexibility in placing transplantable corneas with surgeons and patients throughout the region.

Operating in Missouri, Kansas, and Central Illinois, Heartland Lions Eye Banks is one of the largest eye banks in North America in terms of service area. The Missouri Lions Eye Research Foundation also maintains an agreement with the Lions of Illinois to procure donated eye tissue in parts of Illinois. Heartland Lions Eye Banks maintains files on eye donors and transplant recipients in Missouri, Illinois and Kansas. The HLEB also assists in the training of enucleators throughout this service area. (Enucleation is the surgical technique used to remove donated eyes.)

Heartland Lions Eye Banks is also one of the largest eye banks in North America in terms of providing corneas for transplant. This is due in part to HLEB's operation of the Regional Cornea Distribution Cooperative. HLEB distributes all cornea tissue retrieved by the Wichita Eye Bank (WEB) and the Midwest Transplant Network (MTN). This pooling of tissue again allows for greater efficiency in the distribution of transplantable corneas. Working together with the WEB and the MTN, Heartland Lions Eye Banks was able to provide corneal tissue for 2,306 transplant recipients during 1998.

Heartland Lions Eye Banks focuses on helping the people of Missouri, Illinois and Kansas. Corneas are first made available to patients in need of a transplant in these three states. When all requests for corneal tissue in this primary service area have been filled, remaining eye tissue is offered to surgeons in other parts of the United States. If there is no immediate need in this country, corneas can be offered to surgeons and patients in other nations. This system allows the Missouri Lions Eye Research Foundation to fulfill 100% of the requests it receives for patients in Missouri, Illinois and Kansas. It also allows MLERF to help people throughout the rest of the United States, and all over the world.

To facilitate the eye donation process, a system of enucleation substations has been set up throughout Missouri and Kansas, and in parts of Central and Southern Illinois. The Heartland Lions Eye Banks maintains more than 250 eye enucleation kits in towns across Missouri. Similar substations exist in the state of Kansas, and in the parts of Illinois served by the HLEB. Embalmers, physicians, nurses, and others trained in the process can use these kits to enucleate eyes when an HLEB technician cannot perform the procedure. With this network of enucleators in place, Heartland Lions Eye Banks is able to retrieve donated eye tissue quickly and effectively throughout the three-state service area.

The Missouri Lions Eye Research Foundation appreciates the help it receives from the volunteers who assist in the eye donation process. When eyes are enucleated by a non-staff technician, the eye tissue must then be transported to one of the Heartland Lions Eye Banks laboratories for processing. Lions Club members in Missouri, Kansas, and Illinois volunteer to drive for the HLEB and transport donated eyes to one of the eye banks quickly and safely. The state Highway Patrol, several airlines, and other commercial carriers volunteer their services when Lions Club members are not available. The state Highway Patrol is also able to transport eye tissue in severe weather.

Heartland Lions Eye Banks is a charter member of the Eye Bank Association of America (EBAA), and HLEB technicians become certified when they attend EBAA courses and seminars. Heartland Lions Eye Banks rigidly follows EBAA medical standards, as well as the guidelines set by the Food and Drug Administration (FDA), when processing and evaluating eye tissue. FDA regulations require eye banks to test the donors of transplantable corneas for HIV 1, HIV 2, Hepatitis B, and Hepatitis C. The Missouri Lions Eye Research Foundation houses a serology laboratory, which can test the donor's blood before clearing any donated eye tissue for transplant.

Heartland Lions Eye Banks has experienced steady growth. Some of the growth over the years can be attributed to a new law passed in August of 1998. This law mandates that hospital staff notify an organ procurement agency of all patients who have died in that hospital. If the hospital fails to comply with this ruling, they may lose all or part of their Medicare funding.

All parts of the eye can be used for clinical purposes, not just the cornea. The sclera (white of the eye) can be preserved in glycerin or absolute alcohol, and used months later to repair another patient's sclera, eardrum, nasal septum, or gums. Some donated eyes will yield corneas that are unsuitable for transplant. These eyes, and the parts of the eye that remain after a transplantable cornea has been removed, can be used by research scientists to study the causes and cures of blinding diseases. Most advances in understanding the physiological processes involving the cornea, lens, vitreous, retina, and other structures within the eye have evolved from the study of tissue provided by eye banks. Without this tissue, such studies could not take place.

Heartland Lions Eye Banks provides tissue to the National Disease Research Interchange (NDRI), a non-profit organization which allows biomedical researchers regular access to human tissues and organs. Since its inception in 1980, NDRI's goal has been to provide human tissues to researchers who must corroborate the results of their studies on animal models. By themselves, animal models can be inadequate to investigate many aspects of a disease and its complications. By providing such tissue to NDRI, the Heartland Lions Eye Banks assures that no tissue received by the eye bank goes to waste.

Heartland Lions Eye Banks generally collects a processing fee when it provides corneal tissue for transplant. Processing fees are collected by more than 98% of the eye banks in the country. These fees are used to help cover the costs incurred by eye banks in retrieving and extensively testing the eye tissue they provide. There is never any fee charged to the donor family. Heartland Lions Eye Banks never collects a fee from the transplant recipient either, since:

1. The tissue processing fee is covered by virtually all health insurance companies, and
2. Medicare's "flat rate" fee structure for a corneal transplant procedure allows for a processing fee in its calculation of the payment made to the hospital.

Heartland Lions Eye Banks' processing fee is only charged when a patient has third-party coverage. If a patient does not have insurance, the processing fee is waived. The Foundation's Eye Care Assistance Program provides gratis corneal tissue to needy recipients who do not have third-party coverage.

It is illegal and unethical to charge a fee for any human organs and tissues. Again, the HLEB's processing fee helps to cover expenses incurred in preparing and providing the highest quality eye tissue possible to the patient. Safety is insured by a thorough review of the donor's medical history, microscopic evaluations of the donated eye tissue, donor family interviews, and laboratory testing.

(top of page)