Degree of compatibility for HLA-A and -B affects outcome in high-risk corneal transplantation

BACKGROUND: HLA-A/-B matching on a split typing level is more laborious, more expensive and offers less chances for a well-fitting match than does matching on the conventional broad typing level. It is important, therefore, to investigate whether or not split matching offers advantages and would, therefore, be advisable.

METHODS: 303 high-risk patients out of 2,471 keratoplasty patients from 1982 through 1996, whose histories were all followed prospectively, could be re-evaluated retrospectively according to their broad or split matching levels ('good' vs. 'moderate').

RESULTS: Only a 'good' split level matching was significantly better than a 'moderate' one in the long run (up to 12 years). For the broad level matching this was only true for the first few years after keratoplasty.

CONCLUSION: If only HLA-A/-B are matched and if only results longer than 3-4 years (up to 12 years) are taken into consideration, then split level matching offers clear-cut advantages over broad level matching.