Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1997 Aug;81(8):631–636. doi: 10.1136/bjo.81.8.631

Conclusions of the corneal transplant follow up study

A Vail 1, S Gore 1, B Bradley 1, D Easty 1, C Rogers 1, W Armitage 1
PMCID: PMC1722292  PMID: 9349147

Abstract

AIM—On the basis of finalised data from the Corneal Transplant Follow up Study to identify and quantify factors influencing corneal graft outcome in terms of graft survival, rejection, visual acuity, and astigmatism.
METHODS—Multifactorial analysis of 2777 grafts registered by the UK Transplant Support Service from July 1987 to June 1991.
RESULTS—Several recipient factors influencing graft survival, rejection, and visual acuity were identified, but no donor factors. Of the operative factors amenable to change, mixed suturing was associated with reduced graft survival, and larger grafts with increased risk of rejection but better visual acuity when surviving. There was increased risk of rejection with poor matching at HLA class I antigens, but mismatched HLA-DR grafts suffered less rejection than those with zero HLA-DR mismatches. Recipient age below 10 years was associated with increased risk of both rejection and graft failure. However, whereas increasing age above 10 years was not associated with differential graft survival, it was significantly associated with decreasing risk of rejection.
CONCLUSIONS—While confirming possible benefits of HLA-A and B matching, the expense and delay involved in awaiting matched HLA-DR tissue is unlikely to be justified. Other donor factors are unrelated to graft outcome following screening of tissue by eye banks. The highest rates of graft failure and rejection happen in the early postoperative period, and factors influencing visual outcome are also apparent at this stage.



Full Text

The Full Text of this article is available as a PDF (119.0 KB).

Figure 1  .

Figure 1  

Open in a new tab

Graft survival and 75 day hazard rates.

Figure 2  .

Figure 2  

Open in a new tab

Rejection free graft survival and 75 day hazard rates.   

Figure 3  .

Figure 3  

Open in a new tab

Influence of HLA mismatching on rejection free graft survival, adjusted for other factors.

Figure 4  .

Figure 4  

Open in a new tab

Distributions of corrected visual acuity.

Figure 5  .

Figure 5  

Open in a new tab

Distributions of astigmatism.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Armitage W. J., Easty D. L. Factors influencing the suitability of organ-cultured corneas for transplantation. Invest Ophthalmol Vis Sci. 1997 Jan;38(1):16–24. [PubMed] [Google Scholar]
  2. Bradley B. A., Vail A., Gore S. M., Rogers C. A., Armitage W. J., Nicholls S., Easty D. L. Negative effect of HLA-DR matching on corneal transplant rejection. Transplant Proc. 1995 Feb;27(1):1392–1394. [PubMed] [Google Scholar]
  3. Fagnoni F. F., Vescovini R., Mazzola M., Bologna G., Nigro E., Lavagetto G., Franceschi C., Passeri M., Sansoni P. Expansion of cytotoxic CD8+ CD28- T cells in healthy ageing people, including centenarians. Immunology. 1996 Aug;88(4):501–507. doi: 10.1046/j.1365-2567.1996.d01-689.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Franceschi C., Monti D., Sansoni P., Cossarizza A. The immunology of exceptional individuals: the lesson of centenarians. Immunol Today. 1995 Jan;16(1):12–16. doi: 10.1016/0167-5699(95)80064-6. [DOI] [PubMed] [Google Scholar]
  5. George A. J., Ritter M. A. Thymic involution with ageing: obsolescence or good housekeeping? Immunol Today. 1996 Jun;17(6):267–272. doi: 10.1016/0167-5699(96)80543-3. [DOI] [PubMed] [Google Scholar]
  6. Gore S. M., Vail A., Bradley B. A., Rogers C. A., Easty D. L., Armitage W. J. HLA-DR matching in corneal transplantation. Systematic review of published evidence. Corneal Transplant Follow-up Study Collaborators. Transplantation. 1995 Nov 15;60(9):1033–1039. [PubMed] [Google Scholar]
  7. Pawelec G., Adibzadeh M., Pohla H., Schaudt K. Immunosenescence: ageing of the immune system. Immunol Today. 1995 Sep;16(9):420–422. doi: 10.1016/0167-5699(95)80017-4. [DOI] [PubMed] [Google Scholar]
  8. Sanfilippo F., MacQueen J. M., Vaughn W. K., Foulks G. N. Reduced graft rejection with good HLA-A and B matching in high-risk corneal transplantation. N Engl J Med. 1986 Jul 3;315(1):29–35. doi: 10.1056/NEJM198607033150105. [DOI] [PubMed] [Google Scholar]
  9. Sansoni P., Cossarizza A., Brianti V., Fagnoni F., Snelli G., Monti D., Marcato A., Passeri G., Ortolani C., Forti E. Lymphocyte subsets and natural killer cell activity in healthy old people and centenarians. Blood. 1993 Nov 1;82(9):2767–2773. [PubMed] [Google Scholar]
  10. Steinmann G. G., Klaus B., Müller-Hermelink H. K. The involution of the ageing human thymic epithelium is independent of puberty. A morphometric study. Scand J Immunol. 1985 Nov;22(5):563–575. doi: 10.1111/j.1365-3083.1985.tb01916.x. [DOI] [PubMed] [Google Scholar]
  11. Vail A., Gore S. M., Bradley B. A., Easty D. L., Rogers C. A., Armitage W. J. Influence of donor and histocompatibility factors on corneal graft outcome. Transplantation. 1994 Dec 15;58(11):1210–1216. [PubMed] [Google Scholar]
  12. Vail A., Gore S. M., Bradley B. A., Easty D. L., Rogers C. A., Armitate W. J. Clinical and surgical factors influencing corneal graft survival, visual acuity, and astigmatism. Corneal Transplant Follow-up Study Collaborators. Ophthalmology. 1996 Jan;103(1):41–49. doi: 10.1016/s0161-6420(96)30734-3. [DOI] [PubMed] [Google Scholar]
  13. Vail A., Gore S. M., Bradley B. A., Easty D. L., Rogers C. A. Corneal graft survival and visual outcome. A multicenter Study. Corneal Transplant Follow-up Study Collaborators. Ophthalmology. 1994 Jan;101(1):120–127. doi: 10.1016/s0161-6420(94)31376-5. [DOI] [PubMed] [Google Scholar]
  14. Vail A., Gore S. M., Bradley B. A., Easty D. L., Rogers C. A. Corneal transplantation in the United Kingdom and Republic of Ireland. Br J Ophthalmol. 1993 Oct;77(10):650–656. doi: 10.1136/bjo.77.10.650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Völker-Dieben H. J., D'Amaro J., Kok-van Alphen C. C. Hierarchy of prognostic factors for corneal allograft survival. Aust N Z J Ophthalmol. 1987 Feb;15(1):11–18. doi: 10.1111/j.1442-9071.1987.tb00300.x. [DOI] [PubMed] [Google Scholar]
  16. Williams K. A., Roder D., Esterman A., Muehlberg S. M., Coster D. J. Factors predictive of corneal graft survival. Report from the Australian Corneal Graft Registry. Ophthalmology. 1992 Mar;99(3):403–414. doi: 10.1016/s0161-6420(92)31960-8. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES