Matching of the minor histocompatibility antigen HLA-A1/H-Y may improve prognosis in corneal transplantation.
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.
Böhringer
Daniel
D
Eye Hospital and LIONS Cornea Bank Regio/Baden-Württemberg, University Hospital Freiburg, Germany. daniel.boehringer@uniklinik-freiburg.de
Spierings
Eric
E
Enczmann
Jürgen
J
Böhringer
Stefan
S
Sundmacher
Rainer
R
Goulmy
Els
E
Reinhard
Thomas
T
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
D006182:H-Y Antigen; D015788:HLA-A1 Antigen