By R. Sundmacher, F. Bandello
‘Immunologic privilege’ of the cornea and anterior chamber has, more often than not, been believed to be a adequate warrantly for survival of the donor cornea. If this failed, it was once concept that adjunctive immunomodulating brokers could compensate. however the query of the way to take care of greater tolerance and more secure long term survival of corneal grafts after withdrawal of a powerful immunomodulating defend nonetheless remained unanswered. the answer's human leukocyte antigens (HLA) matching. during this quantity, immunological and scientific facets are mentioned by way of popular medical and experimental immunologists in addition to skilled keratoplasty surgeons. those specialists finish that HLA matching is, in truth, a invaluable adjunct for long term survival of corneal grafts not just in these at excessive danger yet significantly additionally in sufferers at common chance. This quantity opens new pathways in the direction of the winning software of HLA matching to keratoplasty surgeons, experimental and medical immunologists and cornea financial institution officials, whilst appearing as an relief to ophthalmologists whilst discovering the foundation to appropriately suggest their keratoplasty sufferers.
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Additional resources for Adequate HLA Matching in Keratoplasty (Developments in Ophthalmology, 36)
That case is a good example of a normal immune response to an HLA histoincompatibility in an elderly corneal transplant recipient . The significant beneficial effect of HLA-A, -B and -DR typing and matching on the survival of high-risk corneal transplants justifies that practice for all high-risk recipients of corneal transplants. The joint effect of HLA-A, -B and -DR matching which we and others have found suggests that attempts must be made to minimize the number of mismatches by typing and matching recipients and donors for the antigens at those 3 loci.
Dev Opthalmol. Basel, Karger, 1999, vol 30, pp 129–140. Jager MJ: Corneal Langerhans cells and ocular immunology. Reg Immunol 1992;4:186–195. Roelen RL, Datema G, Van Bree S, Zhang L, Van Rood JJ, Claas FHJ: Evidence that antibody formation against a certain HLA alloantigen is associated not with a quantitative but with a qualitative change in the cytotoxic T cells recognizing the same antigen. Transplantation 1992;53: 899–903. Foets BJ, van den Oord JJ, Billiau A, Van Damme J, Missotten L: Heterogeneous induction of major histocompatibility complex class II antigens on corneal endothelium by interferon-␥.
The contrary, however, was observed. (4) In the past, the influence of blood group compatibility on graft prognosis was discussed controversially . It may be important, therefore, that the number of patients with blood group compatibilities was comparable in both study groups. An influence of minor histocompatibility mismatches on graft prognosis was found by Streilein  in the mouse penetrating keratoplasty model. The only minor histocompatibility antigen investigated in this study was H-Y.
Adequate HLA Matching in Keratoplasty (Developments in Ophthalmology, 36) by R. Sundmacher, F. Bandello