Association between corneal allograft reactions and HLA compatibility.
The purpose of this follow-up study is to measure the association between corneal allograft reactions and donor-recipient HLA-A and HLA-B compatibility. Four hundred thirty-eight consecutive adult recipients of corneal grafts with known donor-recipient HLA matching were observed for allograft reactions and failures. Most of the recipients under observation (91%) were well matched for HLA-DR. Of 438 recipients, 158 (36%) completed a 3-year follow-up. Three factors were associated with endothelial allograft reactions: 2 to 4+ corneal vascularization (relative risk, 2.2; P = 0.0006), two mismatched antigens at either the HLA-A or HLA-B locus (relative risk, 2.1; P = 0.0009), and recipient wound size of 8 mm or greater (relative risk, 1.5; P = 0.05). Unexpectedly, a strong association between endothelial allograft reactions and HLA-A or HLA-B incompatibility was found in low-risk recipients defined as unvascularized recipients of a small graft (relative risk, 3.2; P = 0.004). A larger sample size is required to determine if HLA matching offers a solution for recipients with corneal vascularization.
Boisjoly
H M
HM
Centre Hospitalier de l'Université Laval Research Center, Laval University School of Medicine, Québec City, Canada.
Roy
R
R
Bernard
P M
PM
Dubé
I
I
Laughrea
P A
PA
Bazin
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003627:Data Interpretation, Statistical; D004728:Endothelium, Corneal / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival / Q000276:immunology; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006648:Histocompatibility / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014184:Transplantation, Homologous
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens