title: The effect of ABO blood incompatibility on corneal transplant failure in conditions with low-risk of graft rejection.
abstract: OBJECTIVE
  To determine whether corneal graft survival over a 5-year follow-up period was affected by ABO blood type compatibility in participants in the Cornea Donor Study undergoing corneal transplantation principally for Fuchs dystrophy or pseudophakic corneal edema, conditions at low-risk for graft rejection.
  
  
  METHODS
  Multi-center prospective, double-masked, clinical trial.
  
  
  METHODS
  ABO blood group compatibility was determined for 1,002 donors and recipients. During a 5-year follow-up period, episodes of graft rejection were documented, and graft failures were classified as to whether or not they were attributable to immunologic rejection. Endothelial cell density was determined by a central reading center for a subset of subjects.
  
  
  RESULTS
  ABO donor-recipient incompatibility was not associated with graft failure attributable to any cause including graft failure because of rejection, or with the occurrence of a rejection episode. The 5-year cumulative incidence of graft failure attributable to rejection was 32 (6%) for recipients with ABO recipient-donor compatibility and 12 (4%) for those with ABO incompatibility (hazard ratio, 0.65; 95% confidence interval, 0.33 to 1.25; P = .20). The 5-year incidence for a definite rejection episode, irrespective of whether graft failure ultimately occurred, was 64 (12%) for ABO compatible compared with 25 (8%) for ABO incompatible cases (P = .09). Among clear grafts at 5 years, percent loss of endothelial cells was similar in ABO compatible and incompatible cases.
  
  
  CONCLUSIONS
  In patients undergoing penetrating keratoplasty for Fuchs dystrophy or pseudophakic corneal edema, ABO matching is not indicated since ABO incompatibility does not increase the risk of transplant failure attributable to graft rejection.
authors.affiliation: Michigan Cornea Consultants, PC, Southfield, USA. cds@jaeb.org
authors.forename: Steven P
authors.initials: SP
authors.lastname: Dunn
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Stark
authors.forename: R Doyle
authors.initials: RD
authors.lastname: Stulting
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Lass
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
authors.forename: Mark A
authors.initials: MA
authors.lastname: Pavilack
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Smith
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Tanner
authors.forename: Mariya
authors.initials: M
authors.lastname: Dontchev
authors.forename: Robin L
authors.initials: RL
authors.lastname: Gal
authors.forename: Roy W
authors.initials: RW
authors.lastname: Beck
authors.forename: Craig
authors.initials: C
authors.lastname: Kollman
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Mannis
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Holland
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001787:Blood Group Incompatibility / Q000276:immunology*; D002452:Cell Count; D003316:Corneal Diseases / Q000601:surgery; D004728:Endothelium, Corneal; D005260:Female; D006084:Graft Rejection / Q000097:blood*; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012204:Rh-Hr Blood-Group System / Q000276:immunology
chemical_list: D000017:ABO Blood-Group System; D012204:Rh-Hr Blood-Group System