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. 2012 Oct;31(10):1141-7.
doi: 10.1097/ICO.0b013e31823f77f5.

Effect of donor and recipient factors on corneal graft rejection

R Doyle Stulting  1 , Alan Sugar, Roy Beck, Michael Belin, Mariya Dontchev, Robert S Feder, Robin L Gal, Edward J Holland, Craig Kollman, Mark J Mannis, Francis Price Jr, Walter Stark, David D Verdier; Cornea Donor Study Investigator Group
Affiliations

Effect of donor and recipient factors on corneal graft rejection

R Doyle Stulting et al. Cornea. 2012 Oct.

Abstract

Purpose: To assess the relationship between donor and recipient factors and corneal allograft rejection in eyes that underwent penetrating keratoplasty in the Cornea Donor Study.

Methods: Overall, 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs dystrophy or pseudophakic corneal edema) were followed for up to 5 years. Associations of baseline recipient and donor factors with the occurrence of a probable or definite rejection event were assessed in univariate and multivariate proportional hazards models.

Results: Eyes with pseudophakic or aphakic corneal edema (n = 369) were more likely to experience a rejection event than eyes with Fuchs dystrophy (n = 676) [34% ± 6% vs. 22% ± 4%; hazard ratio = 1.56; 95% confidence interval (CI), 1.21-2.03]. Among eyes with Fuchs dystrophy, a higher probability of a rejection event was observed in phakic posttransplant eyes compared with those that underwent cataract extraction with or without intraocular lens implantation during penetrating keratoplasty (29% vs. 19%; hazard ratio = 0.54; 95% CI, 0.36-0.82). Female recipients had a higher probability of a rejection event than male recipients (29% vs. 21%; hazard ratio = 1.42; 95% CI, 1.08-1.87) after controlling for the effect of preoperative diagnosis and lens status. Donor age and donor recipient ABO compatibility were not associated with rejection.

Conclusions: There was a substantially higher graft rejection rate in eyes with pseudophakic or aphakic corneal edema compared to that in eyes with Fuchs dystrophy. Female recipients were more likely to have a rejection event than male recipients. Graft rejection was not associated with donor age.

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Figures

Figure 1
Figure 1
Life Table Plot of Cumulative Probability of Rejection Events (N=1,090) * Includes 45 subjects with variety of diagnoses: 12 with interstitial keratitis, 7 with posterior polymorphous dystrophy, 6 with perforating corneal injury and 20 with other causes of endothelial failure
See this image and copyright information in PMC

References

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