Effect of donor and recipient factors on corneal graft rejection.

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.

• Authors: R Doyle Stulting, 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
• Journal: Cornea (Cornea) Vol. 31 Issue 10 Pg. 1141-7 (Oct 2012) ISSN: 1536-4798 [Electronic] United States
• PMID: 22488114 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Aphakia, Postcataract (complications)
• Child
• Corneal Edema (etiology, surgery)
• Female
• Fuchs' Endothelial Dystrophy (etiology, surgery)
• Graft Rejection (diagnosis, etiology)
• Humans
• Keratoplasty, Penetrating
• Male
• Middle Aged
• Proportional Hazards Models
• Pseudophakia (complications)
• Risk Factors
• Tissue Donors
• Transplantation
• Transplantation, Homologous
• Young Adult