ABO antigen blood‐group compatibility and allograft rejection in corneal transplantation

Abstract

ABSTRACT.Purpose: To evaluate effects of ABO antigen blood-group matching on the rates of corneal allograft rejection after penetrating keratoplasty. Methods: We retrospectively studied clinical results of penetrating keratoplasties in terms of graft survival rates and rejection-free graft survival rates. Penetrating keratoplasties were done on 95 eyes between 1993 and 1997. Clinical results were analyzed using the Kaplan-Meier life table method and log-rank test. The corneal transplantations were classified into 2 groups, high-risk (35 eyes) and low-risk (60 eyes) transplantations. High-risk transplantation was defined as significant vascularization in the recipient corneas or a history of graft failure. The remaining transplantations were defined as low-risk. Results: The respective graft survival (pΩ0.031) and rejection-free graft survival (pΩ0.0097) rates were higher in the low-risk than in the high-risk group. In the high-risk group, the rejection-free graft survival was 68.9% for the ABOcompatible subgroup and 36.4% for the ABO-incompatible subgroup (pΩ0.007). Conclusion: ABO matching is effective in reducing the risk of allograft rejection in high-risk corneal transplantations.

The immunology of corneal xenotransplantation: a review of the literature

“…The role of cytotoxic anti‐donor antibodies in corneal graft rejection remains a matter of discussion [100–103]. Clinical studies suggest that, in some instances, antibodies may contribute to corneal allograft failure if a high‐risk recipient has been sensitized previously to donor alloantigens [104] or if the donor–recipient combination is ABO‐incompatible [103,105]. Similarly, sensitization to xenoantigens has been detrimental to graft survival in rodent models of xenoTx [13,106].…”

Management and prevention of corneal graft rejection

“…Major studies published so far do not recommend ABO matching before corneal transplantation. [ 9 11 12 13 ] It is important to note here that the result of the studies on HLA typing and ABO compatibility must be interpreted carefully because these studies suffer from limitations of variability in the outcome measures analyzed (such as graft survivability rather than rejection-free rate), or inclusion of different cohort (normal risk vs. high-risk keratoplasty) and testing methods for HLA matching. [ 14 ]…”

To Evaluate the Effectiveness of Plasmapheresis as a Method for the Graft Disease Prevention in Patients with Keratoplasty

“…Широкой распространенности операций по трансплантации донорской роговицы способствовал ряд особенностей анатомии и физиологии глаза, обеспечивающих наличие иммунной привилегии роговицы и передней камеры, что позволяет обойтись без системной иммуносупрессии и тканевого типирования при подборе донорского материала. Тем не менее в отношении соблюдения иммунологической совместимости донора и реципиента при трансплантации роговицы имеется противоречивая информация, включая предположения некоторых исследователей, подразумевающие существенную роль совместимости по системе AB0 и HLA в успешном приживлении роговичного трансплантата, особенно при выполнении кератопластики высокого риска [3,[6][7][8]. При развитии болезни трансплантата (БТ) развивается помутнение роговицы, являющееся одной из наиболее распространенных причин потери зрения [5].…”