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. 2001 Nov;85(11):1341–1346. doi: 10.1136/bjo.85.11.1341

Influence of HLA-A, HLA-B, and HLA-DR matching on rejection of random corneal grafts using corneal tissue for retrospective DNA HLA typing

M Bartels 1, H Otten 1, B E van Gelderen 1, A Van der Lelij 1
PMCID: PMC1723772  PMID: 11673303

Abstract

AIM—To establish if coincidental HLA-A, HLA-B, and HLA-DR tissue matching is associated with a reduced likelihood of corneal graft rejection.
METHODS—Organ culture preserved random donor corneas were used for penetrating keratoplasty (PKP). Corneal tissue from all graft recipients and donors or blood samples from recipients after repeated transplantation were obtained in order to perform retrospective molecular HLA typing. A group of 21 recipients with a rejection episode (cases) after corneal transplantation was compared with a control group of non-rejectors (n = 43). 31 graft recipients were considered as high risk patients. The influence of HLA-A, HLA-B, and HLA-DR matching on rejection free graft survival time was analysed with Kaplan-Meyer statistics and Cox regression.
RESULTS—A prolonged rejection free survival time was observed in graft recipients with one or two HLA-A matches (log rank test, p = 0.034). This effect was also observed in high risk graft recipients with one or two HLA-DR matches (log rank test, p = 0.030).
CONCLUSIONS—Coincidental HLA-A and HLA-DR matches were observed and associated with a prolonged rejection free survival time in the total group and in the high risk group, respectively. These results support the beneficial effect of prospective HLA-A and HLA-DR typing upon corneal graft survival.



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Figure 1  .

Figure 1  

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Kaplan-Meier curves indicating rejection free survival of corneal graft recipients with one or two matches at the HLA-A locus is significantly better than those with 0 HLA-A matches (log rank test, p = 0.030, n = 63).

Figure 2  .

Figure 2  

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Kaplan-Meier curves indicating the presence of HLA-B matches did not improve rejection free survival of corneal graft recipients (log rank test, p = 0.50, n = 59).

Figure 3  .

Figure 3  

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Kaplan-Meier curves indicating the presence of HLA-DR matches did not improve rejection free survival of corneal graft recipients (log rank test, p = 0.92, n = 64).

Figure 4  .

Figure 4  

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Kaplan-Meier curves indicating HLA-DR matching in high risk recipients showed a beneficial effect on the rejection free graft survival (log rank test, p = 0.030, n = 31).

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