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[HLA typing in high risk keratoplasty]
N Hirsch1, B Nölle, N Zavazava
1Klinik für Ophthalmologie, Universität Kiel.
Summary
Corneal graft rejection is linked to mismatches in major histocompatibility antigens (HLA). Both HLA class-I and class-II mismatches increase rejection risk, highlighting their importance in corneal transplantation success.
Area of Science:
- Ophthalmology
- Immunology
- Transplantation Science
Context:
- Corneal transplantation is increasingly common due to improved surgical techniques and immunosuppression.
- Graft rejection, primarily due to major histocompatibility antigen (HLA) disparity, remains a significant complication.
- The role of HLA class-I antigens in rejection is established, but class-II antigens require further investigation.
Purpose:
- To investigate the impact of HLA class-I and class-II antigen mismatches on corneal graft rejection.
- To analyze the correlation between HLA typing results and postoperative rejection in high-risk corneal transplant recipients.
Summary:
- This study typed 133 high-risk corneal transplant recipients and their donors for HLA antigens.
- Graft rejection occurred in 25% of patients, with a higher incidence associated with multiple HLA class-I mismatches.
- Patients with HLA-DR locus matches exhibited a lower rate of graft rejection compared to those with mismatches.
Impact:
- Mismatches in both HLA class-I and class-II loci are associated with increased corneal graft rejection rates.
- Beyond HLA matching, factors like graft vascularity and patient presensitization also influence rejection outcomes.
- Further research with larger cohorts and multi-center collaboration is needed to fully elucidate HLA's role in corneal graft rejection.