Histocompatibility (HLA) antigens and keratoplasty.

In 84 cases of keratoplasty, all patients had densely vascularized corneas and a history of prior exposure to HLA antigens by pregnancy, blood transfusion, or previous transplantation. Donors were selected on the basis of a negative crossmatch to avoid donor antigens to which the recipient was preimmunized. The overall rate of graft failure from rejection was 15%. A retrospective analysis of donor-recipient HLA matching in 103 high-risk cases showed no consistent correlation between the number of antigens shared and graft outcome. These findings indicated negative cross-match to be important in donor selection for keratoplasty in high-risk cases.