Histocompatibility and corneal transplantation.
BACKGROUND
HLA typing and matching have been poorly implemented in corneal transplantation, mainly because of inconclusive or contradictory analytical results. Consequently, we studied the immune response of corneal transplant recipients to HLA histoincompatibilities in a large homogeneous study.


METHODS
All corneal transplantations were performed by a single surgeon in a single center between 1976 and 1996. Population genetic and other statistical analyses were performed. Simulation studies assessed the effects of HLA-DR mistypings on analytical results.


RESULTS
Mono- and multivariate analyses identified retransplantation, degree of vascularization, HLA-AB and -DR match grades, endothelial cell count, graft size, recipient gender, storage method and panel-reactive antibodies as significantly influencing the survival of corneal transplants. Simulation studies showed that the beneficial effect of HLA-DR matching is abrogated by HLA-DR mistypings.


CONCLUSIONS
Corneal transplant recipients have a normal immune response to HLA incompatibilities. Demonstration of that fact requires accurate HLA typings.
Völker-Dieben
H J
HJ
Department of Ophthalmology, Vrije Universiteit Medisch Centrum, Amsterdam, The Netherlands. HJM.Voelker-Dieben@VUMC.NL
Schreuder
G M Th
GM
Claas
F H J
FH
Doxiadis
I I N
II
Schipper
R F
RF
Pels
E
E
Persijn
G G
GG
Smits
J
J
D'Amaro
J
J
D002452:Cell Count; D003315:Cornea / Q000276:immunology*; D016039:Corneal Transplantation / Q000276:immunology*; D004728:Endothelium, Corneal / Q000166:cytology; D005260:Female; D006085:Graft Survival / Q000502:physiology; D015234:HLA-A Antigens / Q000276:immunology*; D015235:HLA-B Antigens / Q000276:immunology*; D006684:HLA-DR Antigens / Q000276:immunology*; D006648:Histocompatibility / Q000502:physiology*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D012086:Reoperation
D015234:HLA-A Antigens; D015235:HLA-B Antigens; D006684:HLA-DR Antigens