Effect of donor and recipient factors on corneal graft rejection

R. Doyle Stulting, Alan Sugar, Roy Beck, Michael W Belin, Mariya Dontchev, Robert S. Feder, Robin L. Gal, Edward J. Holland, Craig Kollman, Mark J. Mannis, Francis Price, Walter Stark, David D. Verdier

Research output: Contribution to journalArticle

22 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)1141-1147
Number of pages7
JournalCornea
Volume31
Issue number10
DOIs
StatePublished - Oct 2012

Fingerprint

Graft Rejection
Fuchs' Endothelial Dystrophy
Corneal Edema
Penetrating Keratoplasty
Confidence Intervals
Intraocular Lens Implantation
Corneal Transplantation
Cataract Extraction
Proportional Hazards Models
Cornea
Lenses
Allografts

Keywords

  • corneal allograft rejection
  • corneal transplantation
  • graft failure

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Stulting, R. D., Sugar, A., Beck, R., Belin, M. W., Dontchev, M., Feder, R. S., ... Verdier, D. D. (2012). Effect of donor and recipient factors on corneal graft rejection. Cornea, 31(10), 1141-1147. https://doi.org/10.1097/ICO.0b013e31823f77f5

Effect of donor and recipient factors on corneal graft rejection. / Stulting, R. Doyle; Sugar, Alan; Beck, Roy; Belin, Michael W; Dontchev, Mariya; Feder, Robert S.; Gal, Robin L.; Holland, Edward J.; Kollman, Craig; Mannis, Mark J.; Price, Francis; Stark, Walter; Verdier, David D.

In: Cornea, Vol. 31, No. 10, 10.2012, p. 1141-1147.

Research output: Contribution to journalArticle

Stulting, RD, Sugar, A, Beck, R, Belin, MW, Dontchev, M, Feder, RS, Gal, RL, Holland, EJ, Kollman, C, Mannis, MJ, Price, F, Stark, W & Verdier, DD 2012, 'Effect of donor and recipient factors on corneal graft rejection', Cornea, vol. 31, no. 10, pp. 1141-1147. https://doi.org/10.1097/ICO.0b013e31823f77f5
Stulting RD, Sugar A, Beck R, Belin MW, Dontchev M, Feder RS et al. Effect of donor and recipient factors on corneal graft rejection. Cornea. 2012 Oct;31(10):1141-1147. https://doi.org/10.1097/ICO.0b013e31823f77f5
Stulting, R. Doyle ; Sugar, Alan ; Beck, Roy ; Belin, Michael W ; Dontchev, Mariya ; Feder, Robert S. ; Gal, Robin L. ; Holland, Edward J. ; Kollman, Craig ; Mannis, Mark J. ; Price, Francis ; Stark, Walter ; Verdier, David D. / Effect of donor and recipient factors on corneal graft rejection. In: Cornea. 2012 ; Vol. 31, No. 10. pp. 1141-1147.
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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.",
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T1 - Effect of donor and recipient factors on corneal graft rejection

AU - Stulting, R. Doyle

AU - Sugar, Alan

AU - Beck, Roy

AU - Belin, Michael W

AU - Dontchev, Mariya

AU - Feder, Robert S.

AU - Gal, Robin L.

AU - Holland, Edward J.

AU - Kollman, Craig

AU - Mannis, Mark J.

AU - Price, Francis

AU - Stark, Walter

AU - Verdier, David D.

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N2 - 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.

AB - 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.

KW - corneal allograft rejection

KW - corneal transplantation

KW - graft failure

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