Effectiveness of histocompatibility matching in high-risk corneal transplantation: a summary of results from the Collaborative Corneal Transplantation Studies.

N. Fink, W. J. Stark, M. G. Maguire, D. Stulting, R. Meyer, G. Foulks, R. E. Smith, P. Rapoza

Research output: Contribution to journalArticle

Abstract

The Collaborative Corneal Transplantation Studies (CCTS) were designed to evaluate the effect of donor-recipient histocompatibility matching and crossmatching on the survival of corneal transplants in high-risk patients. Corneas were allocated to the 419 patients in the double-masked Antigen Matching Study on the basis of HLA-A,-B and HLA-DR antigen match. ABO blood group compatibility was determined but not used for recipient selection. The 37 patients in the Crossmatch Study were randomly assigned to receive a cornea from either a positively or negatively crossmatched donor. All patients received topical steroid therapy according to a standard protocol. Matching for HLA-A,-B and HLA-DR antigens had no effect on overall graft survival, the incidence of irreversible rejection, or the incidence of rejection episodes. The positive group in the Crossmatch Study had fewer graft failures, rejection failures, and rejection episodes than the negative group; however, these differences were not statistically significant. The estimated proportion of eyes with failure from rejection by 3 years was 30% for the ABO-incompatible group and 16% for the ABO-compatible group (relative risk, 1.98; 95% confidence interval, 1.15 to 3.13). These studies demonstrate that, for high-risk patients who are immunosuppressed by topical steroid therapy: 1) neither HLA-A.-B nor HLA-DR antigen matching substantially reduced the likelihood of corneal graft failure; 2) a positive donor-recipient crossmatch did not increase the risk of corneal graft failure; and 3) ABO blood group matching may be effective in reducing the risk of graft failure from rejection.

Original languageEnglish (US)
Pages (from-to)3-12
Number of pages10
JournalCeskoslovenská oftalmologie
Volume50
Issue number1
StatePublished - Feb 1994

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Histocompatibility
Corneal Transplantation
HLA-A Antigens
HLA-B Antigens
HLA-DR Antigens
Graft Rejection
Tissue Donors
Blood Group Antigens
Transplants
Cornea
Steroids
Incidence
Graft Survival
Confidence Intervals
Antigens
Therapeutics

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Effectiveness of histocompatibility matching in high-risk corneal transplantation : a summary of results from the Collaborative Corneal Transplantation Studies. / Fink, N.; Stark, W. J.; Maguire, M. G.; Stulting, D.; Meyer, R.; Foulks, G.; Smith, R. E.; Rapoza, P.

In: Ceskoslovenská oftalmologie, Vol. 50, No. 1, 02.1994, p. 3-12.

Research output: Contribution to journalArticle

Fink, N, Stark, WJ, Maguire, MG, Stulting, D, Meyer, R, Foulks, G, Smith, RE & Rapoza, P 1994, 'Effectiveness of histocompatibility matching in high-risk corneal transplantation: a summary of results from the Collaborative Corneal Transplantation Studies.', Ceskoslovenská oftalmologie, vol. 50, no. 1, pp. 3-12.
Fink, N. ; Stark, W. J. ; Maguire, M. G. ; Stulting, D. ; Meyer, R. ; Foulks, G. ; Smith, R. E. ; Rapoza, P. / Effectiveness of histocompatibility matching in high-risk corneal transplantation : a summary of results from the Collaborative Corneal Transplantation Studies. In: Ceskoslovenská oftalmologie. 1994 ; Vol. 50, No. 1. pp. 3-12.
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abstract = "The Collaborative Corneal Transplantation Studies (CCTS) were designed to evaluate the effect of donor-recipient histocompatibility matching and crossmatching on the survival of corneal transplants in high-risk patients. Corneas were allocated to the 419 patients in the double-masked Antigen Matching Study on the basis of HLA-A,-B and HLA-DR antigen match. ABO blood group compatibility was determined but not used for recipient selection. The 37 patients in the Crossmatch Study were randomly assigned to receive a cornea from either a positively or negatively crossmatched donor. All patients received topical steroid therapy according to a standard protocol. Matching for HLA-A,-B and HLA-DR antigens had no effect on overall graft survival, the incidence of irreversible rejection, or the incidence of rejection episodes. The positive group in the Crossmatch Study had fewer graft failures, rejection failures, and rejection episodes than the negative group; however, these differences were not statistically significant. The estimated proportion of eyes with failure from rejection by 3 years was 30{\%} for the ABO-incompatible group and 16{\%} for the ABO-compatible group (relative risk, 1.98; 95{\%} confidence interval, 1.15 to 3.13). These studies demonstrate that, for high-risk patients who are immunosuppressed by topical steroid therapy: 1) neither HLA-A.-B nor HLA-DR antigen matching substantially reduced the likelihood of corneal graft failure; 2) a positive donor-recipient crossmatch did not increase the risk of corneal graft failure; and 3) ABO blood group matching may be effective in reducing the risk of graft failure from rejection.",
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