Short- and Long-Term Results of Xenogeneic-Free Cultivated Autologous and Allogeneic Limbal Epithelial Stem Cell Transplantations
Short- and Long-Term Results of Xenogeneic-Free Cultivated Autologous and Allogeneic Limbal Epithelial Stem Cell Transplantations
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DOI：
10.1097/ico.0000000000002153
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发表时间：
2019-12-01
期刊：
影响因子：
2.8
通讯作者：
Dhubhghaill, Sorcha Ni
中科院分区：
文献类型：
--
作者：
Behaegel, Josephine;Zakaria, Nadia;Dhubhghaill, Sorcha Ni
目的：评价无异种培养角膜缘上皮干细胞移植（CLET）治疗角膜缘干细胞缺乏症（LSCD）的短期和长期成功率。方法：13例LSCD患者接受了自体（n = 9）或异体（n = 4） CLET。主要目的是评估至少3年随访后移植移植物的长期解剖学成功率，并与短期结果进行比较。次要终点包括回顾功能改善，患者报告的症状，以及短期和长期角膜血管化面积百分比的变化。结果：平均短期和长期随访时间分别为2.1 +/- 0.38年和6.7 +/- 1.81年。总解剖成功率短期为46.1%，但长期下降至23.1%。短期和长期的部分成功率均为30.8%，失败率从23.1%上升到46.1%。血管面积平均百分比由术前的12.11% +/- 5.29%下降到短期的7.82% +/- 6.70%，长期上升到8.70% +/- 6.32%。短期最佳矫正视力有显著改善（P = 0.044），但长期无显著改善（P = 0.865）。结论：本研究表明，CLET的解剖和功能成功率随着时间的推移而降低。我们认为，成功率的下降与疾病的程度、细胞来源和缺乏生态位保护有关，因为从长期来看，总LSCD和自体供体细胞赋予了更高的成功率。
Purpose: To evaluate the short- and long-term success rates of xenogeneic-free cultivated limbal epithelial stem cell transplantation (CLET) for the treatment of limbal stem cell deficiency (LSCD).Methods: Thirteen patients with LSCD underwent an autologous (n = 9) or allogeneic (n = 4) CLET. The primary end point was to assess the long-term anatomical success rate of transplanted grafts at a follow-up of at least 3 years, in comparison with the short-term outcomes. Secondary end points involved reviewing functional improvement, patient-reported symptoms, and change in percentage area of corneal vascularization in both short-term and long-term.Results: The mean short- and long-term follow-up periods were 2.1 +/- 0.38 years and 6.7 +/- 1.81 years, respectively. The total anatomical success rate was 46.1% in the short-term, but it decreased to 23.1% in the long-term. A partial success rate of 30.8% was observed in both short- and long-term, and the failure rate increased from 23.1% to 46.1%. The mean percentage of vessel area decreased from 12.11% +/- 5.29% preoperatively to 7.82% +/- 6.70% in the short-term and increased to 8.70% +/- 6.32% in the long-term. There was a significant improvement in best-corrected visual acuity (P = 0.044) in the short-term although not in the long-term (P = 0.865).Conclusions: This study shows that anatomical and functional success rates of CLET decrease over time. We believe that the decline of success is related to the extent of disease, cell origin, and lack of niche protection because subtotal LSCD and autologous donor cells confer a higher chance of success in the long-term.