From the Royal Liverpool University Hospital, Liverpool, UK (V.R, G.C, K.I, S.B.K); Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK (V.R, S.B.K).
UCL Institute of Ophthalmology, London, UK (M.P).
Am J Ophthalmol. 2022 Mar;235:204-210. doi: 10.1016/j.ajo.2021.09.029. Epub 2021 Oct 6.
To investigate whether donor to recipient gender or H-Y mismatching was associated with graft rejection or failure following Descemet stripping automated endothelial keratoplasty (DSAEK) in patients with Fuchs endothelial corneal dystrophy (FECD).
Clinical cohort study.
This study used a multi-center registry including patients aged >18 years who had undergone their first DSAEK for FECD between January 2008 and March 2018. The impact of donor and recipient gender incompatibility (including H-Y mismatches) on corneal graft rejection and failure was evaluated using Kaplan-Meier curves and univariable and multivariable Cox models.
Outcome data from 4341 eyes (3915 from the UK and 426 from Italy) were analyzed. Graft failure at 2-year follow-up occurred in 477 (11.0%) cases. Graft rejection at 2-year follow-up occurred in 175 cases (4.0%), 58 (1.3%) of whom developed graft failure. There was no significant effect of gender or H-Y mismatching on either rejection (P = .12, P = .06) or failure (P = .28, P = .14), respectively.
In patients with FECD undergoing DSAEK, no significant influence of gender and or H-Y mismatch on graft rejection or failure was found.
研究在接受富克斯角膜内皮营养不良（FECD）的患者中，供体与受体性别或 H-Y 不匹配是否与 Descemet 撕囊自动角膜内皮移植术（DSAEK）后的移植物排斥或失败有关。
临床队列研究。
本研究使用了一个多中心登记处，包括 2008 年 1 月至 2018 年 3 月期间首次接受 DSAEK 治疗 FECD 的年龄大于 18 岁的患者。使用 Kaplan-Meier 曲线和单变量及多变量 Cox 模型评估供体和受体性别不匹配（包括 H-Y 不匹配）对角膜移植物排斥和失败的影响。
对来自英国的 3915 只眼和意大利的 426 只眼的 4341 只眼的结果数据进行了分析。在 2 年随访时发生移植物失败的有 477 例（11.0%）。在 2 年随访时发生移植物排斥的有 175 例（4.0%），其中 58 例（1.3%）发生移植物失败。性别或 H-Y 不匹配对排斥（P=0.12，P=0.06）或失败（P=0.28，P=0.14）均无显著影响。
在接受 DSAEK 治疗的 FECD 患者中，未发现性别和或 H-Y 不匹配对移植物排斥或失败有显著影响。
