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HLA-A, HLA-B and HLA-DR matching reduces the rate of corneal allograft rejection

Graefe's Archive for Clinical and Experimental Ophthalmology volume 241, pages 1020–1028 (2003)Cite this article

Abstract

Purpose

The purpose of this study is to determine the effectiveness of HLA typing in preventing corneal allograft rejection.

Methods

This retrospective single-center study analyzed 459 consecutive HLA-typed patients who underwent perforating keratoplasty (PKP) between 1983 and 2001. Grafts were postoperatively transparent after donor-recipient selection by HLA-A, -B and -DR typing. Patients were divided into a low- and a high-risk group based on their preoperative diagnosis.

Results

The estimated 1-, 5- and 10-year graft survival (Kaplan-Meier) was 93, 88 and 67% in low-risk patients and 73, 43 and 38% in high-risk patients. We found a significant correlation between the number of HLA mismatches and the rate of allograft rejections: a donor-recipient match of two or more alleles in HLA-A, -B or -DR reduces the rejection rate by at least 10% in low-risk (10 years after PKP; P<0.04) and 40% in high-risk patients (3 years after PKP; P<0.0001). Especially HLA-B mismatches are important prognostic factors for both low- (P<0.008) and high-risk patients (P<0.003). Considering both HLA-B and -DR mismatches significantly reduces the rate of allograft rejection, particularly in high-risk patients (P<0.0001). Matching on a split typing level offers no significant advantage over broad level matching.

Conclusion

Clinical results confirm theories developed to explain the function of the HLA (MHC) receptor. The closest possible donor-recipient match of HLA antigens based on broad level typing significantly reduces the rate of allograft rejection and thus improves the prognosis for long-term transparency of corneal grafts in both high- and low-risk patients.

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Acknowledgements

We are grateful to Ulrike Geidner, Suzanne Hoppe, Baerbel Kirschbaum and Nora Wendt for expert technical assistance.

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Affiliations

  1. Department of Ophthalmology, Charité University Medicine, Berlin, Benjamin Franklin Campus, Hindenburgdamm 30, 12200 , Berlin, Germany

    Riad Khaireddin, Joachim Wachtlin & Friedrich Hoffmann

  2. Department of Biostatistics, Charité University Medicine, Berlin, Benjamin Franklin Campus, Berlin, Germany

    Werner Hopfenmüller

Authors
  1. Riad Khaireddin
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  2. Joachim Wachtlin
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  3. Werner Hopfenmüller
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  4. Friedrich Hoffmann
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Corresponding author

Correspondence to Riad Khaireddin.

Additional information

This work was presented in part at the 100th meeting of the German Society of Ophthalmology, Berlin, 26–29 September 2002

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Khaireddin, R., Wachtlin, J., Hopfenmüller, W. et al. HLA-A, HLA-B and HLA-DR matching reduces the rate of corneal allograft rejection. Graefe's Arch Clin Exp Ophthalmol 241, 1020–1028 (2003). https://doi.org/10.1007/s00417-003-0759-9

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Keywords

  • Allograft Rejection
  • Corneal Graft
  • Donor Cornea
  • Immunologic Rejection
  • Corneal Allograft