title: [Rejection of corneal allografts].
abstract: Corneal graft rejection is the major cause of penetrating keratoplasty failure. It is a complex immunological process that involves recognition of alloantigens from the corneal graft by the host's immune system, leading to an efferent immune response against the graft. Each layer of the cornea can undergo rejection, endothelial rejection being the most severe form. In some cases, rejection will lead to corneal graft failure. Many donor- and host-related risk factors contribute to corneal graft rejection. Corticosteroid therapy, topical or systemic, is the gold-standard in the preventive and curative treatment of rejection. Other immunosuppressive agents are promising but require further evaluation. Early detection of rejection is essential to establish an aggressive treatment and reduce the risk of graft failure. Prevention of rejection is also based on tissue matching between donor and recipient. In high-risk patients, ABO compatibility decreases the risk of rejection. HLA compatibility could positively influence corneal graft survival in some cases.
authors.affiliation: Service V, centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75571 Paris cedex 12, France. emmanuel.guilbert@free.fr
authors.forename: E
authors.initials: E
authors.lastname: Guilbert
authors.forename: L
authors.initials: L
authors.lastname: Laroche
authors.forename: V
authors.initials: V
authors.lastname: Borderie
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology; D003316:Corneal Diseases / Q000601:surgery; D016510:Corneal Neovascularization / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D016039:Corneal Transplantation; D004359:Drug Therapy, Combination; D004728:Endothelium, Corneal / Q000276:immunology / Q000473:pathology; D019573:Epithelium, Corneal / Q000276:immunology / Q000473:pathology; D005136:Eye Proteins / Q000276:immunology; D005602:France / Q000453:epidemiology; D006084:Graft Rejection / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control; D006680:HLA Antigens / Q000276:immunology; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007519:Isoantigens / Q000276:immunology; D016131:Lymphocyte Subsets / Q000276:immunology; D012307:Risk Factors; D017154:Stromal Cells / Q000276:immunology / Q000473:pathology; D014184:Transplantation, Homologous / Q000276:immunology*
chemical_list: D000017:ABO Blood-Group System; D005136:Eye Proteins; D006680:HLA Antigens; D007166:Immunosuppressive Agents; D007519:Isoantigens