Corneal graft survival in HLA-A- and HLA-B-matched transplantations in high-risk cases with retrospective review of HLA-DR compatibility.

In 107 HLA-A- and HLA-B-matched corneal transplantations performed in high-risk patients, the 3-year graft survival was 60.5%. The criteria used for the definition of high risk were vascularization of the recipient cornea and/or one or more previous failed grafts; they were also the indications for HLA typing and matching. Donor/recipient compatibility was defined by the presence of only 0 or 1 HLA-A or HLA-B mismatches. When non-immunological factors leading to graft failure were excluded, the 3-year survival was 76.3%. During that follow-up period, a total of 33 grafts failed; in 13 cases, the cause was allograft rejection. When only first transplants were considered, a 3-year graft survival of 81.0% was observed. Retrospective DR typing was possible in 33 cases. Because only three graft rejections occurred in that group, we were unable to assess the importance of DR compatibility on the survival of corneal allografts.