Predisposing factors in corneal graft rejection.
During a period of 12 years, 390 patients were treated with perforating keratoplasty and given regular annual follow-ups. Of these, 357 records were evaluated, and there was a 20% incidence of immunoreactions. The transplants were assessed according to four criteria and subdivided into a low-risk and a high-risk group. For high-risk patients, the relative risk of developing an immunoreaction was 2.9 times greater with subdivision according to the preoperative diagnosis, 2.1 times greater with a transplant diameter of 7.5 mm or more, 2.6 times greater with compatibility between fewer than two HLA-B or -DR antigens of the donor and recipient, and 4.2 times greater with blood or fibrin in the anterior chamber on the first postoperative day. There was a linear relation between the frequency of being placed into the less-favorable-prognosis group and the occurrence of an immunoreaction.
Hoffmann
F
F
Department of Ophthalmology, Steglitz Medical Center, Free University of Berlin, West Germany.
Pahlitzsch
T
T
D002648:Child; D003315:Cornea / Q000276:immunology; D016039:Corneal Transplantation; D003524:Cyclosporins / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005500:Follow-Up Studies; D006084:Graft Rejection; D015234:HLA-A Antigens / Q000276:immunology; D015235:HLA-B Antigens / Q000276:immunology; D006684:HLA-DR Antigens / Q000276:immunology; D006650:Histocompatibility Testing; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D011379:Prognosis; D012307:Risk Factors; D014181:Transplantation Immunology
D003524:Cyclosporins; D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D003907:Dexamethasone; D007213:Indomethacin