Long-term outcome in high-risk corneal transplantation and the influence of HLA-A and HLA-B matching

Marjolijn C Bartels, Ilias I N Doxiadis, Thomas P Colen, W Houdijn Beekhuis

    Research output: Contribution to journalArticleResearchpeer-review


    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 languageEnglish
    Pages (from-to)552-6
    Number of pages5
    Issue number6
    Publication statusPublished - Aug 2003


    • 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


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