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HLA-A, HLA-B and HLA-DR matching reduces the rate of corneal allograft rejection

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Abstract

Purpose

The purpose of this study is to determine the effectiveness of HLA typing in preventing corneal allograft rejection.

Methods

This retrospective single-center study analyzed 459 consecutive HLA-typed patients who underwent perforating keratoplasty (PKP) between 1983 and 2001. Grafts were postoperatively transparent after donor-recipient selection by HLA-A, -B and -DR typing. Patients were divided into a low- and a high-risk group based on their preoperative diagnosis.

Results

The estimated 1-, 5- and 10-year graft survival (Kaplan-Meier) was 93, 88 and 67% in low-risk patients and 73, 43 and 38% in high-risk patients. We found a significant correlation between the number of HLA mismatches and the rate of allograft rejections: a donor-recipient match of two or more alleles in HLA-A, -B or -DR reduces the rejection rate by at least 10% in low-risk (10 years after PKP; P<0.04) and 40% in high-risk patients (3 years after PKP; P<0.0001). Especially HLA-B mismatches are important prognostic factors for both low- (P<0.008) and high-risk patients (P<0.003). Considering both HLA-B and -DR mismatches significantly reduces the rate of allograft rejection, particularly in high-risk patients (P<0.0001). Matching on a split typing level offers no significant advantage over broad level matching.

Conclusion

Clinical results confirm theories developed to explain the function of the HLA (MHC) receptor. The closest possible donor-recipient match of HLA antigens based on broad level typing significantly reduces the rate of allograft rejection and thus improves the prognosis for long-term transparency of corneal grafts in both high- and low-risk patients.

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Acknowledgements

We are grateful to Ulrike Geidner, Suzanne Hoppe, Baerbel Kirschbaum and Nora Wendt for expert technical assistance.

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Authors and Affiliations

  1. Department of Ophthalmology, Charité University Medicine, Berlin, Benjamin Franklin Campus, Hindenburgdamm 30, 12200 , Berlin, Germany

    Riad Khaireddin, Joachim Wachtlin & Friedrich Hoffmann

  2. Department of Biostatistics, Charité University Medicine, Berlin, Benjamin Franklin Campus, Berlin, Germany

    Werner Hopfenmüller

Authors
  1. Riad Khaireddin
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  2. Joachim Wachtlin
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  3. Werner Hopfenmüller
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  4. Friedrich Hoffmann
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Corresponding author

Correspondence to Riad Khaireddin.

Additional information

This work was presented in part at the 100th meeting of the German Society of Ophthalmology, Berlin, 26–29 September 2002

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Khaireddin, R., Wachtlin, J., Hopfenmüller, W. et al. HLA-A, HLA-B and HLA-DR matching reduces the rate of corneal allograft rejection. Graefe's Arch Clin Exp Ophthalmol 241, 1020–1028 (2003). https://doi.org/10.1007/s00417-003-0759-9

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