Corneal Transplantation and Histocompatibility

Endothelia of 102 clear human corneal grafts in 95 patients were photographed in 7 i v n with a specular microscope. The relation of the endothelial cell density to the HLA and ARO compatibility of the donor-recipient pairs were studied. In addition, the effects of vascularization and reversible rejection on the endothelial cell density were analysed. A negative correlation was found between the HLA incompatibility and the endothelial cell density of the graft. The group with 0-1 (2) mismatches had the highest endothelial cell density (1356 k 510 cells/mm2). This result was better than in the group with 2 (3) mismatches, but the cell difference was not statistically significant. A statistically significant difference in average endothelial cell densities was found between the groups with 0-1 (2) mismatches and with 3-4 mismatches, the latter having 880 k 475 cells/mm2 (P < 0.01).There was also a statistically significant difference in average endothelial cell densities between the group with 0-1 mismatch and the untyped group ( P < 0.01). The difference in cell densities between the group with 2 (3) mismatches and the more incompatible groups together (3-4 mismatches and the untyped group) was statistically almost significant (P < 0.05).The ABO-compatible pairs had 18% more endothelial cells than the ABOincompatible pairs. The difference was not statistically significant, but when the ABO-compatible pairs were compared with all the others (incompatible and untyped), the difference in mean cell density between the two groups was statistically almost significant (P < 0.05).Comparison of the effect of tissue incompatibility on graft endothelial cell density separately in the patients with vascularized and non-vascularized

Section: Discussionmentioning

confidence: 99%

Histocompatibility and Corneal Graft Endothelium

Ruusuvaara

1979

“…One of these, the last one in the Table, later cleared up. This patient was reported in detail by Ehlers & Ahrons (1971a). The preoperative pathology, especially the presence of vessels in the cornea, probably influences the occurrence of lymphocytosis, the occurrence of graft rejection and the final result.…”

Section: Observationsmentioning

confidence: 88%

Conjunctival Lymphocytosis After Corneal Transplantation

Ehlers¹,

Ahrons²

1973

Self Cite

Conjunctival lymphocytosis was followed after penetrating corneal transplantations. Examinations were made of scrapings taken with the spatula and stained according to May-Grunwald-Giemsa. In a series of 22 ABO compatible transplantations a semi-quantitative correlation was found between the HL-A compatibility and the degree of lymphocytosis in the second to fifth postoperative month. It is suggested that conjunctival lymphocytosis reflects immune processes in the cornea. Clinical use of the method could probably be made in the second or third month when strong lymphocytosis would contraindicate a reduction or indicate a n initiation of immunosuppressive therapy.

“…The HLA-compatibility is usually found to be a much more important factor in corneal graft than ABO-com- Table I . ABO-compatibility and graft sensitivity. patibility (Ehlers & Ahrons 1971;Ehlers & Kissmeyer-Nielsen 1973, 1977Batchelor 1976). This study suggests that the ABO-compatibility might influence the regeneration of nerve fibres.…”

Section: Discussionmentioning

confidence: 99%

Reinnervation of the Corneal Graft

Skriver

1978

Corneal graft reinnervation was studied in 45 patients. The reinnervation was correlated to donodrecipient compatibility (HLA and ABO). The sensitivity tended to be normal about 12 months after transplantation.Previous studies on corneal graft reinnervation have shown that sensitivity appears gradually after about 6 weeks (Broberg-Ans 1952). Sensitivity never becomes fully normal, irrespective of the fate of the graft.In recent years the technique of operation has been considerably refined, a fact that might influence the reinnervation. W e therefore decided to reinvestigate the sensitivity of corneal grafts. Materials and MethodsThis study comprises 45 patients subjected to corneal transplantation (45 penetrating grafts).The series comprised 12 cases of keratoconus, 9 cases of herpetic keratitis, 7 cases of non-herpetic keratitis, 10 cases of dystrophy, and 7 cases of traumatic lesions. The material comprises 23 males and 22 females with an age range between 20 and 79 years and an average age of 45 years.The operation technique and postoperative care has been reported elsewhere (Ehlers 1977). HLA-and ABO-compatibility between donor and recipient was determined for all the 45 penetrating transplantations. Corneal sensitivity was measured with the aesthesiometer of Cochet-Bonnet. A nylon filament of thickness 0.12 mm was applied.The sensitivity was considered normal, when the pressure of a filament 2 50 mm could