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Andrea Stadnikova, Aref Al-Fakih, Katerina Jirsova, ; A lower number of rejection episodes occurs in patients treated with corneal grafts stored in organ cultures compared to corneas stored under hypothermic conditions. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4024.
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To determine retrospectively the percentage of rejection episodes (immune reaction treated therapeutically) and corneal graft failures due to rejection in patients after penetrating keratoplasty (PK). Previously, we have found that the number of antigen-presenting cells significantly decreases during the storage of corneas in organ cultures in comparison to hypothermic conditions. Patients received corneas stored either under hypothermic conditions or in organ cultures, cultured for less than or longer than 14 days.
Five hundred ten patients after PK were assessed for rejection episodes or corneal graft failure due to rejection. Two hundred twenty-five patients received corneas stored under hypothermic conditions (group I), 222 patients received corneas stored in organ cultures for less than 14 days (group II), and 63 patients received corneas stored in organ cultures for longer than 14 days (group III). Patients were followed-up after PK for 1-6 years. In each group we also evaluated the patients based on their having a normal or higher risk of rejection (vascularization, inflammation, rekeratoplasty).
Taken together, in group I we detected 24 % of rejections during the follow-up period, in group II 16 %, and in group III 14 %. In groups I, II, and III the rejection rates were 23%, 14% and 13% of patients with a normal risk of rejection and 27%, 22% and 16% of patients with a higher risk of rejection, respectively. A graft failure due to rejection occurred in only one patient in group I.
The lowest percentage of rejections was present in patients treated with corneas stored in organ cultures for longer than 14 days (group III). This result is very likely due to the pronounced decrease in the number of HLA-DR-positive cells during organ cultivation and makes organ culture-stored corneas preferable for the prevention of corneal graft rejection.<br /> Acknowledgments: This work was supported by project 7F14156, Ministry of Education, Youth and Sports.
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