Abstract
PURPOSE: To evaluate long-term follow-up of high-risk corneal transplants allocated after matching for broad HLA-A and HLA-B antigens and to establish whether matching for HLA-A and -B antigen "splits" would result in a reduced risk of immunologic graft failure.
METHODS: A total of 303 high risk corneal transplants was included. Class I antigen-matched donor corneas were obtained using broad HLA-A and -B antigen data and accepting 0 or 1 mismatch at each locus. Analysis of HLA antigens was performed also on the split typing level. The influence on immunologic graft failure for an increasing number of matched class I antigens based on split typing was analyzed with Kaplan-Meier statistics and Cox regression. Graft survival and indication for transplantation were investigated.
RESULTS: Rejection was the cause of 34% of all graft failures. A significantly higher immune failure free graft survival was found in a group with 0 or 1 HLA-A and -B mismatch based on split typing (log-rank test, P = 0.002). A beneficial effect of matching for split antigens was shown with multivariate analysis (odds ratio, 0.41).
CONCLUSIONS: One third of graft failures in our high-risk population was caused by irreversible graft rejection. Allocation of donor corneas based on a 0 or 1 split antigen mismatch at both HLA-A and -B loci could contribute to a higher immune failure free graft survival and could result in a higher overall graft survival.
Original language | English |
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Pages (from-to) | 552-6 |
Number of pages | 5 |
Journal | Cornea |
Volume | 22 |
Issue number | 6 |
DOIs | |
Publication status | Published - Aug 2003 |
Keywords
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Child, Preschool
- Corneal Transplantation
- Female
- Graft Rejection/epidemiology
- Graft Survival
- HLA-A Antigens/analysis
- HLA-B Antigens/analysis
- Histocompatibility Testing
- Humans
- Incidence
- Longitudinal Studies
- Male
- Middle Aged
- Multivariate Analysis
- Retrospective Studies
- Risk Factors
- Treatment Outcome