Effect of donor and recipient factors on corneal graft rejection.
Effect of donor and recipient factors on corneal graft rejection.
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DOI：
10.1097/ico.0b013e31823f77f5
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发表时间：
2012-10
期刊：
影响因子：
2.8
通讯作者：
Cornea Donor Study Investigator Group
中科院分区：
文献类型：
--
作者：
Stulting RD;Sugar A;Beck R;Belin M;Dontchev M;Feder RS;Gal RL;Holland EJ;Kollman C;Mannis MJ;Price F Jr;Stark W;Verdier DD;Cornea Donor Study Investigator Group
在角膜供体研究中，评估供体和受体因素与接受穿透性角膜移植术（PK）的患眼的角膜移植排斥反应之间的关系。对1090例因中度风险疾病（主要是Fuchs营养不良或人工晶状体角膜水肿）接受角膜移植的受试者进行了长达5年的随访。在单变量和多变量比例风险模型中评估了基线受体和供体因素与可能或确定的排斥事件发生的相关性。人工晶状体或无晶状体角膜水肿眼（N=369）比Fuchs营养不良眼（N=676）更可能发生排斥事件（34% ± 6% vs 22% ± 4%;风险比= 1.56; 95%置信区间1.21 - 2.03）。在患有Fuchs营养不良的患眼中，与PK期间接受白内障摘除术伴或不伴眼内透镜植入的患眼相比，在有晶状体的移植后患眼中观察到更高的排斥事件概率（29% vs. 19%;风险比= 0.54; 95%置信区间0.36 - 0.82）。在控制术前诊断和透镜状态的影响后，女性受者发生排斥事件的概率高于男性（29% vs. 21%;风险比=1.42; 95%置信区间1.08 - 1.87）。供体年龄和供体受体ABO血型相容性与排斥反应无关。与Fuchs营养不良眼相比，人工晶状体眼或无晶状体眼角膜水肿眼的移植物排斥率明显较高。女性受者比男性更容易发生排斥事件。移植物排斥反应与供体年龄无关。
To assess the relationship between donor and recipient factors and corneal allograft rejection in eyes that underwent penetrating keratoplasty (PK) in the Cornea Donor Study. 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. 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% versus 22% ± 4%; hazard ratio = 1.56; 95% confidence interval 1.21 to 2.03). Among eyes with Fuchs’dystrophy, a higher probability of a rejection event was observed in phakic post-transplant eyes compared with eyes that underwent cataract extraction with or without intraocular lens implantation during PK (29% vs. 19%; hazard ratio = 0.54; 95% confidence interval 0.36 to 0.82). Female recipients had a higher probability of a rejection event than males (29% vs. 21%; hazard ratio=1.42; 95% confidence interval 1.08 to 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. There was a substantially higher graft rejection rate in eyes with pseudophakic or aphakic corneal edema compared with eyes with Fuchs’ dystrophy. Female recipients were more likely to have a rejection event than males. Graft rejection was not associated with donor age.