Inoue K, Amano S, Oshika T, Tsuru T
Department of Ophthalmology, Branch Hospital, Faculty of Medicine, University of Tokyo, Japan.
Eye (Lond). 2000 Apr;14 ( Pt 2):201-5. doi: 10.1038/eye.2000.54.
To assess the effects of histocompatibility Y (H-Y) antigen matching on the rate of corneal allograft rejection after penetrating keratoplasty (PKP).
We retrospectively investigated the graft survival rate and rejection-free graft survival rate after PKP in 396 eyes. The compatible combinations of H-Y antigen included male donors and male recipients (n = 135), female donors and male recipients (n = 107), and female donors and female recipients (n = 60). Incompatible combination was from male donors and female recipients (n = 94). The eyes were classified into two groups--high-risk (168 eyes) and low-risk (228 eyes)--depending on the degree of vascularisation in the recipient corneas or a history of previous allograft rejection. Data were analysed using the Kaplan-Meier life table method, the log-rank test and the Cox proportional hazards model.
In both the high-risk and low-risk groups, the graft survival and rejection-free graft survival rates were not affected by the H-Y compatibility. The graft survival (p < 0.001) and rejection-free graft survival (p < 0.001) rates were higher in the low-risk group than in the high-risk group. High-risk PKP was associated with greater risk of graft failure (risk ratio, 2.33) and rejection (risk ratio, 2.05) than low-risk PKP.
H-Y antigen matching does not influence the rate of allograft rejection after PKP.
评估组织相容性Y(H-Y)抗原匹配对穿透性角膜移植术(PKP)后角膜移植排斥反应发生率的影响。
我们回顾性研究了396只眼PKP后的移植物存活率和无排斥反应的移植物存活率。H-Y抗原的相容组合包括男性供体与男性受体(n = 135)、女性供体与男性受体(n = 107)以及女性供体与女性受体(n = 60)。不相容组合为男性供体与女性受体(n = 94)。根据受体角膜的血管化程度或既往同种异体移植排斥反应史,将这些眼睛分为两组——高危组(168只眼)和低危组(228只眼)。采用Kaplan-Meier生存表法、对数秩检验和Cox比例风险模型对数据进行分析。
在高危组和低危组中,移植物存活率和无排斥反应的移植物存活率均不受H-Y相容性的影响。低危组的移植物存活率(p < 0.001)和无排斥反应的移植物存活率(p < 0.001)均高于高危组。与低危PKP相比,高危PKP发生移植物失败(风险比,2.33)和排斥反应(风险比,2.05)的风险更高。
H-Y抗原匹配不影响PKP后同种异体移植排斥反应的发生率。