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供体年龄对进口供体角膜原发性穿透性角膜移植术中移植物存活的影响。

Effect of Donor Age on Graft Survival in Primary Penetrating Keratoplasty with Imported Donor Corneas.

作者信息

Kwon Hyeon Yoon, Hyon Joon Young, Jeon Hyun Sun

机构信息

Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea.

Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.

出版信息

Korean J Ophthalmol. 2020 Feb;34(1):35-45. doi: 10.3341/kjo.2019.0086.

Abstract

PURPOSE

To investigate the influence of donor age on corneal graft survival following primary penetrating keratoplasty (PK) with imported donor corneas.

METHODS

The eyes of patients who underwent primary PK with imported donor corneas were classified retrospectively into two groups according to a donor-age cutoff of 65 years. Primary outcome measures were rejection-free graft survival and graft survival. Cox proportional hazard regression analysis was used to assess the factors affecting graft survival. Survival analysis was performed using the Kaplan-Meier method, while differences between groups were examined using a log-rank test. A subgroup analysis of low- and high-risk eyes according to preoperative diagnosis was also performed.

RESULTS

A total of 140 eyes from 138 patients (age, 58 ± 18 years) were enrolled. Cox regression analysis revealed that the donor age of 65 years or older group presented an increased risk of both graft rejection and failure. Survival analysis revealed that rejection-free graft survival and graft survival rates were higher in eyes in the donor age of less than 65 years group. Finally, in the subgroup analysis, both rejection-free graft survival and graft survival rates were significantly higher in the donor age of less than 65 years group than in the donor age of 65 years or older group, but only in the low-risk subgroup.

CONCLUSIONS

Donor age may correlate with graft survival in primary PK performed with imported donor corneas. Donor age could be a considerable factor in primary PK with imported donor corneas, especially in preoperatively low-risk patients.

摘要

目的

探讨供体年龄对采用进口供体角膜进行初次穿透性角膜移植术(PK)后角膜移植存活情况的影响。

方法

对接受进口供体角膜初次PK的患者的眼睛,根据65岁的供体年龄界限进行回顾性分组。主要观察指标为无排斥反应的移植存活情况和移植存活情况。采用Cox比例风险回归分析评估影响移植存活的因素。使用Kaplan-Meier方法进行生存分析,同时使用对数秩检验检查组间差异。还根据术前诊断对低风险和高风险眼进行了亚组分析。

结果

共纳入138例患者(年龄58±18岁)的140只眼睛。Cox回归分析显示,65岁及以上供体年龄组出现移植排斥和失败的风险增加。生存分析显示,供体年龄小于65岁组的眼睛无排斥反应的移植存活率和移植存活率更高。最后,在亚组分析中,供体年龄小于65岁组的无排斥反应移植存活率和移植存活率均显著高于65岁及以上供体年龄组,但仅在低风险亚组中。

结论

在采用进口供体角膜进行的初次PK中,供体年龄可能与移植存活相关。供体年龄可能是采用进口供体角膜进行初次PK的一个重要因素,尤其是在术前低风险患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aef9/7010478/86168965a26c/kjo-34-35-g001.jpg

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