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捐赠-移植过程与角膜移植失败:一项病例对照研究。

The donation-transplantation process and corneal graft failure: A case-control study.

作者信息

Pereira Cruz Giovanna Karinny, Ferreira Júnior Marcos Antonio, Pereira Santos Viviane Euzébia, Vitor Allyne Fortes, Pereira Frota Oleci, Ferraz Teston Elen, Machado Mota Felipe, Gonçalves Zulin Maria Eduarda, Moura Maidana Gustavo, Lima Meza Letícia, Dias Abes Bruna, Dias Mayra

机构信息

Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil.

出版信息

PLoS One. 2025 May 22;20(5):e0321225. doi: 10.1371/journal.pone.0321225. eCollection 2025.

Abstract

INTRODUCTION

The survival after a corneal transplantation depends on several factors, many of which are not fully known.

OBJECTIVE

The present study aimed to verify the relationship between the factors inherent to the donation-transplantation process in graft failure.

MATERIALS AND METHODS

Longitudinal case-control study carried out in a reference service in corneal transplantation in northeastern Brazil, which included transplanted patients with corneal graft failure and their respective controls. The sample consisted of 27 cases of graft failure and 54 controls.

RESULTS

A total of 427 transplantations were performed between 2010 and 2016 in the studied service, during which 27 cases of corneal graft failure were identified, representing a failure rate of 9.04%. The intergroup descriptive analysis identified the predominance of corneal graft failure in females (cases: 59.26%; control: 55.56%), brown (cases: 65.38%; controls: 53.70%), single (cases: 71.43%; controls: 68.52%) and residents in the capital and metropolitan region (cases: 66.67%; controls: 50%). The mean age of the patients who underwent corneal transplantation was 52.31 years (cases: 56.15 years; control: 50.39 years). Regarding the "type of keratoplasty", the prevalence of penetrating keratoplasty was observed in 87.65% of the transplantations (cases: 81.48%; controls: 18.52%). In addition, 85.19% of the failures were late and 46.91% of the patients subjected to transplantation had already undergone an ophthalmological surgical procedure previously.

CONCLUSION

The present study identified the following variables as factors of the donation-transplantation process associated with corneal graft failure: donor button size ≤ 8.25 mm, donor-recipient button size difference less than 0.25 mm, death due to respiratory failure, time interval between enucleation-preservation and corneal endothelial disorder.

摘要

引言

角膜移植后的存活率取决于多种因素,其中许多因素尚未完全明确。

目的

本研究旨在验证移植失败的供体 - 移植过程中固有因素之间的关系。

材料与方法

在巴西东北部一家角膜移植参考服务机构进行纵向病例对照研究,纳入角膜移植失败的患者及其各自的对照。样本包括27例移植失败病例和54例对照。

结果

2010年至2016年期间,在所研究的服务机构共进行了427例移植手术,其中27例角膜移植失败,失败率为9.04%。组间描述性分析发现角膜移植失败在女性(病例:59.26%;对照:55.56%)、棕色人种(病例:65.38%;对照:53.70%)、单身者(病例:71.43%;对照:68.52%)以及首都和大都市地区居民(病例:66.67%;对照:50%)中占主导。接受角膜移植患者的平均年龄为52.31岁(病例:56.15岁;对照:50.39岁)。关于“角膜移植类型”,87.65%的移植手术采用穿透性角膜移植(病例:81.48%;对照:18.52%)。此外,85.19%的失败为晚期,46.91%接受移植的患者此前已接受过眼科手术。

结论

本研究确定了以下变量为与角膜移植失败相关的供体 - 移植过程因素:供体植片大小≤8.25毫米、供体 - 受体植片大小差异小于0.25毫米、因呼吸衰竭死亡、眼球摘除 - 保存与角膜内皮病变之间的时间间隔。

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本文引用的文献

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Immunopathogenesis of corneal graft rejection.角膜移植排斥反应的免疫发病机制。
Indian J Ophthalmol. 2023 May;71(5):1733-1738. doi: 10.4103/IJO.IJO_2866_22.
2
Update on the genetics of corneal endothelial dystrophies.角膜内皮营养不良的遗传学研究进展。
Indian J Ophthalmol. 2022 Jul;70(7):2239-2248. doi: 10.4103/ijo.IJO_992_22.
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Cornea donation process and tissue quality for transplantation.角膜移植的捐献流程与组织质量
PLoS One. 2021 Apr 20;16(4):e0249927. doi: 10.1371/journal.pone.0249927. eCollection 2021.
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Corneal graft failure: an update.角膜移植失败:更新。
Br J Ophthalmol. 2021 Aug;105(8):1049-1058. doi: 10.1136/bjophthalmol-2020-316705. Epub 2020 Aug 11.
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Access of the black population to health services: integrative review.黑人对医疗服务的可及性:综合评价。
Rev Bras Enferm. 2020;73(4):e20180834. doi: 10.1590/0034-7167-2018-0834. Epub 2020 Jun 1.

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