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Typisierung beim HLA-Matching

Vorteile für die Keratoplastik

Typing for HLA matching

Advantages for keratoplasty

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Zusammenfassung

Das Abgleichen der humanen Leukozytenantigene (HLA-Matching) von Organspender und -empfänger hat eine große klinische Bedeutung bei der Nieren-, Herz-, Lungen- und Knochenmarkstransplantation. Neuere Daten zeigen, dass ein HLA-Matching das Transplantatüberleben auch nach Hornhauttransplantationen signifikant verlängert. Ursachen der späten Akzeptanz der Bedeutung des HLA-Matchings bei Keratoplastik sind einerseits das immunologische Privileg des Auges, welches Hornhauttransplantationen auch ohne immunsuppressive Therapie unter bestimmten Bedingungen möglich macht, und andererseits die mit einer hohen Fehlerquote behaftete serologische HLA-Typisierung. Die heutzutage durchgeführte molekularbiologische DNA-Typisierung ist nahezu fehlerfrei, und eine Auswahl des Transplantats aufgrund ihrer Ergebnisse wird das Langzeitüberleben von Hornhauttransplantaten in Zukunft weiter verbessern. Eine Vielzahl von Gründen spricht heute für den generellen Einsatz des HLA-Matchings bei Keratoplastik.

Abstract

Matching of human leukocyte antigens of donors and recipients (HLA matching) plays a significant role in kidney, heart, lung, and stem cell transplantation. New data demonstrate that HLA matching also significantly prolongs the survival of corneal grafts. The reasons for the late recognition of the significance of HLA matching in corneal transplantation are on the one hand the immune privilege of the eye, which allows corneal transplantation under certain conditions without immunosuppressive therapy, and on the other hand highly erroneous serological typing. Recent molecular DNA typing is almost without errors, and the selection of grafts on the basis of results obtained using this method will improve the long-time survival of future corneal grafts. Today, there are several reasons arguing for the general practice of HLA matching in keratoplasty.

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Authors and Affiliations

  1. Institut für Mikrobiologie und Hygiene, Charite – Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland

    R. Ignatius

  2. Augenklinik, Charite – Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Deutschland

    F. Hoffmann

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  1. R. Ignatius
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  2. F. Hoffmann
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Correspondence to F. Hoffmann.

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Ignatius, R., Hoffmann, F. Typisierung beim HLA-Matching. Ophthalmologe 104, 213–218 (2007). https://doi.org/10.1007/s00347-006-1469-6

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