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

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.

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').

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.

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.