Department of Ophthalmology, Flinders University, Adelaide, Australia.
Am J Transplant. 2010 Apr;10(4):921-930. doi: 10.1111/j.1600-6143.2009.03002.x. Epub 2010 Feb 1.
We investigated whether a rejection episode in one graft was associated with rejection in the other graft, in recipients with bilateral corneal transplants. In a prospectively maintained, national register of 14,865 followed corneal grafts, 1476 patients with bilateral penetrating corneal grafts were identified. Occurrence of rejection was a risk factor for graft failure (p < 0.0001). Logistic regression was used to calculate the adjusted odds ratio for rejection in one eye following rejection in the other eye. In the subset of 1118 patients with bilateral grafts but no history of previous grafts or rejections in either eye, the adjusted odds ratio for a rejection episode in the first eye following rejection in the second was 3.27 (95% confidence interval, CI 1.85, 5.79; p < 0.001). The adjusted odds ratio was 2.04 (95% CI 1.07, 3.91; p = 0.03) for rejection in the second eye following rejection in the first. The median time between the first rejection episode in one eye and the first rejection episode in the other eye was 15 months. Patients with bilateral corneal grafts who suffer a graft rejection episode in one eye are at significantly greater odds of suffering a rejection episode in the other corneal transplant.
我们研究了在接受双侧角膜移植的患者中，一只移植眼中发生排斥反应是否与另一只移植眼中的排斥反应有关。在一个前瞻性维护的、包含 14865 例随访角膜移植的全国登记处中，确定了 1476 例双侧穿透性角膜移植患者。排斥反应的发生是移植物失功的危险因素（p<0.0001）。使用逻辑回归计算了在一只眼发生排斥反应后另一只眼发生排斥反应的调整比值比。在没有先前任何一只眼的移植或排斥反应史的 1118 例双侧移植患者亚组中，第二只眼发生排斥反应后第一只眼发生排斥反应的调整比值比为 3.27（95%置信区间，CI 1.85，5.79；p<0.001）。第一只眼发生排斥反应后第二只眼发生排斥反应的调整比值比为 2.04（95%置信区间，CI 1.07，3.91；p=0.03）。一只眼发生首次排斥反应与另一只眼发生首次排斥反应之间的中位时间为 15 个月。在一只眼发生移植物排斥反应的双侧角膜移植患者中，另一只角膜移植发生排斥反应的几率明显更高。
