When penetrating keratoplasty is indicated, special attention should be given to (1) the compliance of the patient, (2) sufficient treatment of herpes keratitis or other infections, (3) adequate immunosuppression in autoimmune corneal inflammation, (4) double running continuous sutures as primary suture with sometimes additional single sutures to stabilize the graft, and (5) surgery in time.
SUMMARYThe objective of this study was to investigate the expression of MHC antigens by retinal pigment epithelium cells (RPE) after stimulation with interferon-gamma (U-N--/) and to improve the currently practised technique of cadaver HLA typing. A concentration of 100 U/ml lFN-y induced expression of class I molecules up to >90% 3 days after stimulation, whereas 50 U/mi were required for the expression of HLA-DR to > 90%. A concentration of 750 U/ml induced 35-45% expression of HLA-DP and <25% HLA-DQ after 3 days. Cells were scrologically typed using the standard lymphocytotoxicity assay 3 days after stimulation with 250 U/ml IFN-y. Typing of class I specificities was complemented by onc-dimcnsiona! isoelectric focusing (ID-IEF). We observed high concordance between the results of the RPE typing and the lymphocytotoxicily test on the same donors. Our results show complete typing of class I and 11 antigens post-mortem, which, in particular, enables graft matching and improvement of graft survival in recipients of organs removed many hours after death such as the cornea.
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