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Histocompatibility and corneal transplantation
H J Völker-Dieben1, G M Th Schreuder, F H J Claas
1Department of Ophthalmology, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands. HJM.Voelker-Dieben@VUMC.NL
Developments in Ophthalmology
|December 24, 2002
Summary
Accurate human leukocyte antigen (HLA) typing is crucial for corneal transplant success. This study found that precise HLA matching significantly impacts graft survival, underscoring the need for reliable typing methods.
Area of Science:
- Immunogenetics
- Ophthalmology
- Transplantation immunology
Background:
- Human leukocyte antigen (HLA) typing and matching are underutilized in corneal transplantation due to inconsistent results.
- Previous studies have yielded inconclusive or contradictory findings regarding HLA's role in corneal graft survival.
Purpose of the Study:
- To investigate the immune response of corneal transplant recipients to HLA histoincompatibilities.
- To identify factors influencing corneal transplant survival in a large, homogeneous cohort.
Main Methods:
- Corneal transplantations performed by a single surgeon at a single center (1976-1996).
- Population genetic and statistical analyses were conducted.
- Simulation studies evaluated the impact of human leukocyte antigen-DR (HLA-DR) mistypings on analytical outcomes.
Main Results:
- Retransplantation, vascularization, HLA-AB and HLA-DR match grades, endothelial cell count, graft size, recipient gender, storage method, and panel-reactive antibodies significantly affected corneal graft survival.
- Simulation results indicated that human leukocyte antigen-DR (HLA-DR) mistypings negate the benefits of HLA-DR matching.
Conclusions:
- Corneal transplant recipients exhibit a typical immune response to human leukocyte antigen (HLA) incompatibilities.
- Accurate human leukocyte antigen (HLA) typing is essential for demonstrating the impact of HLA matching on corneal transplant outcomes.