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Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Related Experiment Video

Updated: Aug 11, 2025

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty
10:46

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

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Risk Factors for Descemet Membrane Endothelial Keratoplasty Rejection: Current Perspectives- Systematic Review.

Bharat Gurnani1, Kirandeep Kaur2, Vaitheeswaran Ganesan Lalgudi3

  • 1Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Madhya Pradesh, India.

Clinical Ophthalmology (Auckland, N.Z.)
|February 9, 2023
PubMed
Summary

Descemet membrane endothelial keratoplasty (DMEK) rejection is less common but requires prompt diagnosis and management with steroids. Early intervention is key for graft survival and visual acuity.

Keywords:
DMEK rejectiondescemet membrane endothelial keratoplastyprimary graft failurerebubblingsecondary graft failure

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Last Updated: Aug 11, 2025

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Full-Field Optical Coherence Microscopy for Histology-Like Analysis of Stromal Features in Corneal Grafts
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Area of Science:

  • Ophthalmology
  • Transplantation Surgery
  • Immunology

Background:

  • Descemet membrane endothelial keratoplasty (DMEK) selectively replaces defective endothelium.
  • Corneal graft rejection can occur at multiple levels, with DMEK rejection being less common than DSAEK or PKP.
  • Understanding DMEK rejection is crucial for maintaining graft survival and visual acuity.

Purpose of the Study:

  • To provide a comprehensive review of Descemet membrane endothelial keratoplasty (DMEK) rejection.
  • To update knowledge on risk factors, pathophysiology, diagnosis, prevention, and management of DMEK rejection.
  • To discuss differential diagnoses, prognosis, and future perspectives for DMEK graft failure and rejection.

Main Methods:

  • Comprehensive literature search using Google Scholar, PubMed, and Google Books.
  • Synthesis of existing research on DMEK rejection.
  • Review of clinical manifestations, diagnostic approaches, and treatment strategies.

Main Results:

  • DMEK rejection, while less common, presents with varied clinical signs, sometimes more subtle than in DSAEK.
  • Prompt diagnosis and intensive management, primarily with topical steroids, are essential for successful outcomes.
  • Graft failure necessitates further procedures like repeat DMEK, DSEK, or penetrating keratoplasty (PKP).

Conclusions:

  • Early detection and intervention are critical for managing DMEK rejection and preserving graft function.
  • Current management relies heavily on topical steroids, with systemic options for severe cases.
  • This review addresses a gap in comprehensive literature on DMEK rejection, offering insights for clinicians and researchers.