Effect of donor and recipient factors on corneal graft rejection

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, Walter Stark, David D. Verdier

Research output: Contribution to journalArticle

24 Scopus citations

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

Keywords

  • corneal allograft rejection
  • corneal transplantation
  • graft failure

ASJC Scopus subject areas

  • Ophthalmology

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    Stulting, R. D., Sugar, A., Beck, R., Belin, M., Dontchev, M., Feder, R. S., Gal, R. L., Holland, E. J., Kollman, C., Mannis, M. J., Price, F., Stark, W., & 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