INFLUENCE OF DONOR AND HISTOCOMPATIBILITY FACTORS ON CORNEAL GRAFT OUTCOME

The Corneal Transplant Follow-up Study has followed 2311 penetrating k eratoplasties for up to 450 days after transplant, A total of 207 fail ures were observed, including 65 classical rejections and 35 endotheli al decompensations, At 12 months, graft survival was 89%, and survival free from rejection was 87%. For surviving grafts, risk of failure re duced from 4.8% in the first 75 days and stabilized after 5 months at 1.2% in each 75-day interval. Risk of rejection initially followed a s imilar pattern, but then increased after 12 months. Multifactorial ana lyses accounted for differences in recipient characteristics and inter relationships of donor factors. Donor age, sex, cause of death, and me thod of corneal storage were not found to influence significantly eith er time to graft failure or time to first rejection. Grafts in prospec tively tissue-typed donor-recipient pairs were generally considered be fore surgery to be at increased risk of either graft failure or reject ion. With due allowance, increasing risk of rejection was associated w ith increasing numbers of mismatches at HLA-A and HLA-B broad antigens . The opposite was true at HLA-DR broad antigens, where increased risk of rejection was observed with no mismatches.