The global eyecare and eye bank community has unveiled the world’s first global agreement on the use of donated human tissue for ocular transplantation, research, and future technologies.

Named the ‘Barcelona Principles’, as it was unveiled at an event in Barcelona, hosted by the Global Alliance of Eye Bank Associations (GAEBA), the Centro de Barraquer Ophthalmology Centre and Barcelona Tissue Bank, the agreement provides new ethical guidelines for the use of donated eye tissue.

“The Barcelona Principles has evolved due to the global community seeking guidance on current ethical dilemmas – where they seek to improve tissue access to millions of waiting recipients – without compromise of their personal moral integrity and professional custodian responsibilities to the donor, recipient and the extended community,” said Dr Graeme Pollock, GAEBA representative and director of the Lions Eye Donation Service in Melbourne, in an announcement.

The Barcelona Principles present nine key strategies for managing eye tissue donations and their use in medicine and research, their retention as a public resource and their accessibility for recipients. “Collectively, the Barcelona Principles support nations and regions to tackle allocation and equitable access issues in their own jurisdiction, aiding policy and practice development and recommendations for cross-border engagement,” said Dr Pollock. “The Barcelona Principles also address areas of ethical ambiguity – namely profitisation and supply chains to for-profits, and their use in research and product development.

“The global community is concerned about the emergence and development of a “market mentality” around donations and the Barcelona Principles includes a clear statement that it is our collective responsibility to protect and retain stewardship of altruistic donations as a public resource for the shared benefit of all.”

The agreement’s nine strategies include:

• Respect the autonomy of the donor and their next-of-kin in the consent process
• Protect the integrity of the altruistic and voluntary donation and its utility as a public resource for the shared benefit of all
• Support sight restoration and ocular health for recipients
• Promote fair, equitable and transparent allocation mechanisms
• Uphold the integrity of the custodian’s profession in all jurisdictions
• Develop high-quality services that promote ethical CTO (cells/tissues/organs) management, traceability and utility
• Develop local/national self-sufficient services
• Recognise and address the potential ethical, legal and clinical implications of cross-border activities
• Ensure ethical practice and governance of research (non-therapeutic) requiring cells, tissue and/or organs

The Barcelona Principles adheres to the World Health Organisation’s (WHO’s) ‘Guiding Principles on Human Cell, Tissue and Organ Transplantation’ and were signed in the presence of Dr Jose Nunez from the WHO’s Medical Products of Human Origin Service Delivery and Safety Department and Dr Paul Dubord representing WHO’s expert advisory panel on human cell, tissue and organ transplantation.