title: Matching of the minor histocompatibility antigen HLA-A1/H-Y may improve prognosis in corneal transplantation.
abstract: BACKGROUND
  Minor histocompatibility (H) antigens are peptides of allelic intracellular proteins that play an important role in human leukocyte antigen (HLA) matched transplantations. In an animal model of keratoplasty, minor H antigens have even been reported to exceed the immunogenicity of major H antigens (MHC). This investigation is to assess any benefit of matching the broadly expressed gender (H-Y) and HA-3 antigens in HLA-A1 donor positive human keratoplasty.
  
  
  METHODS
  A total of 229 HLA-A1 donor positive keratoplasties were analyzed. A Cox proportional hazards model and Kaplan-Meier analysis were applied to estimate the effect of H-Y or HA-3 mismatches on rejection-free graft survival.
  
  
  RESULTS
  Eighty-one cases were mismatched for H-Y (male donor to female recipient). A mean follow up of two years showed graft survival as high as 88% in the H-Y compatible group compared to only 77% in the H-Y mismatched group (P = 0.02). Eight out of 62 cases were mismatched for HA-3. No statistically significant influence of HA-3 matching on rejection-free graft survival was observed (85% vs. 73%, P=0.52).
  
  
  CONCLUSIONS
  HLA-A1/H-Y matching and matching for other broadly expressed minor H antigens may further improve prognosis in keratoplasty.
authors.affiliation: Eye Hospital and LIONS Cornea Bank Regio/Baden-Württemberg, University Hospital Freiburg, Germany. daniel.boehringer@uniklinik-freiburg.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Böhringer
authors.forename: Eric
authors.initials: E
authors.lastname: Spierings
authors.forename: Jürgen
authors.initials: J
authors.lastname: Enczmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Böhringer
authors.forename: Rainer
authors.initials: R
authors.lastname: Sundmacher
authors.forename: Els
authors.initials: E
authors.lastname: Goulmy
authors.forename: Thomas
authors.initials: T
authors.lastname: Reinhard
mesh_terms: D000368:Aged; D000483:Alleles; D003316:Corneal Diseases / Q000235:genetics* / Q000276:immunology*; D016039:Corneal Transplantation / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006085:Graft Survival; D006182:H-Y Antigen / Q000235:genetics*; D015788:HLA-A1 Antigen / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D016896:Treatment Outcome
chemical_list: D006182:H-Y Antigen; D015788:HLA-A1 Antigen