Original articleThe Effect of ABO Blood Incompatibility on Corneal Transplant Failure in Conditions with Low-risk of Graft Rejection
Section snippets
Methods
Details of the CDS protocol have been reported previously.1, 5, 6 Briefly, subjects were between 40 and 80 years of age, with a diagnosed corneal condition associated with endothelial dysfunction that placed them at moderate risk of overall graft failure but low-risk of graft rejection, principally Fuchs dystrophy and pseudophakic corneal edema. Clinical investigators and subjects were masked to all characteristics of the donor corneal tissue, including age, endothelial cell density, and donor
Results
The characteristics of the cohort included in this study were similar to those of the full CDS population reported previously.5, 6 Sixty-four percent of the recipients were ABO compatible with their donor, 86% were Rh compatible, and 54% were both ABO and Rh compatible. ABO/Rh compatibility did not vary by any recipient or donor demographics including self-reported race/ethnicity (data not shown).
As seen in Table 1, graft failure attributable to rejection was not impacted by ABO compatibility.
Discussion
A search for immunologic factors that reduce graft survival has led researchers to examine the cornea for the presence of markers capable of inciting a rejection reaction. Among those examined have been human leukocyte antigen (HLA) Group I and Group II antigens, the ABO blood group antigens, and Lewis antigen. Studies of these antigens have shown some interesting, thought provoking, and controversial results.
The CCTS investigated, in a prospective study, the relationship between corneal
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Matching for Human Leukocyte Antigens (HLA) in corneal transplantation - To do or not to do
2015, Progress in Retinal and Eye ResearchCitation Excerpt :This type of rejection has been described in solid organ transplantation and is mediated by circulating antibodies, directed against ABO-blood group or HLA antigens or both; such antibodies may have developed as the result of a previous antigen exposure, such as a blood transfusion or pregnancy (Wood and Goto, 2012). With regard to corneal allografts, early studies found an influence of ABO incompatibility in high risk patients (Inoue and Tsuru, 1999; Maguire et al., 1994), but more recent studies did not confirm this (Dunn et al., 2009; Soma et al., 2004; Stulting et al., 2012). In contrast to the clear role which anti-HLA alloantibodies have in solid organ transplantation, their role is not entirely clear in corneal transplantation.
Comparative cost-effectiveness analysis of descemet stripping automated endothelial keratoplasty versus penetrating keratoplasty in the United States
2013, American Journal of OphthalmologyCitation Excerpt :However, given that the rates are similar after the 2 different surgical procedures, it is unlikely that a slight increase in graft failure rate resulting from new-onset glaucoma would affect the cost-effectiveness analysis significantly. The current literature supports a lower allograft rejection rate for DSAEK than for PK (5.9% vs 10.6%, respectively).10,20,22–28 Based on our model, even with DSAEK rejection rates as high as 28%, DSAEK would remain a dominant procedure over PK.
Rejection of corneal allografts
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