Skip Navigation LinksHome > October 2012 - Volume 31 - Issue 10 > Effect of Donor and Recipient Factors on Corneal Graft Rejec...
doi: 10.1097/ICO.0b013e31823f77f5
Clinical Science

Effect of Donor and Recipient Factors on Corneal Graft Rejection

Stulting, R. Doyle MD, PhD*; Sugar, Alan MD; Beck, Roy MD, PhD; Belin, Michael MD§; Dontchev, Mariya MPH; Feder, Robert S. MD; Gal, Robin L. MSPH; Holland, Edward J. MD; Kollman, Craig PhD; Mannis, Mark J. MD**; Price, Francis Jr MD††; Stark, Walter MD‡‡; Verdier, David D. MD§§; for the Cornea Donor Study Investigator Group

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Purpose: To assess the relationship between donor and recipient factors and corneal allograft rejection in eyes that underwent penetrating keratoplasty in the Cornea Donor Study.

Methods: Overall, 1090 subjects undergoing corneal transplantation for a moderate risk condition (principally Fuchs dystrophy or pseudophakic corneal edema) were followed for up to 5 years. Associations of baseline recipient and donor factors with the occurrence of a probable or definite rejection event were assessed in univariate and multivariate proportional hazards models.

Results: Eyes with pseudophakic or aphakic corneal edema (n = 369) were more likely to experience a rejection event than eyes with Fuchs dystrophy (n = 676) [34% ± 6% vs. 22% ± 4%; hazard ratio = 1.56; 95% confidence interval (CI), 1.21–2.03]. Among eyes with Fuchs dystrophy, a higher probability of a rejection event was observed in phakic posttransplant eyes compared with those that underwent cataract extraction with or without intraocular lens implantation during penetrating keratoplasty (29% vs. 19%; hazard ratio = 0.54; 95% CI, 0.36–0.82). Female recipients had a higher probability of a rejection event than male recipients (29% vs. 21%; hazard ratio = 1.42; 95% CI, 1.08–1.87) after controlling for the effect of preoperative diagnosis and lens status. Donor age and donor recipient ABO compatibility were not associated with rejection.

Conclusions: There was a substantially higher graft rejection rate in eyes with pseudophakic or aphakic corneal edema compared to that in eyes with Fuchs dystrophy. Female recipients were more likely to have a rejection event than male recipients. Graft rejection was not associated with donor age.

© 2012 Lippincott Williams & Wilkins, Inc.


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