Purpose:
A cohort of liver transplanted patients was recruited, to investigate whether systemic gene therapy in the form of liver transplant can influence the risk of developing age-related macular degeneration (AMD). Of note, the liver is the predominant site of complement protein production in the body. This includes complement factor H (CFH), a regulator of the alternate complement pathway. Mutations in the CFH gene, have been strongly associated with AMD. The primary study hypothesis is that systemic replacement of a mutated CFH gene with a wild-type copy, via liver transplant, can reduce the risk of developing AMD. The prevalence of AMD in this cohort, is presented.
Methods:
Patients over 55 years old of Caucasian origin with a history of liver transplantation at least 5 years previously were recruited at 4 specialist liver transplant centres in the UK, over an 18 month period. Dilated fundus examination and photos were taken for AMD grading via a standard scale (Age-Related Eye Disease Study AREDS grading). Bloods were also taken for recipient genotyping, and donor tissue retrieved for donor genotyping.
Results:
197 patients with gradable eyes have been recruited to date. The mean age (+/- 1 SD) was 66.8 +/- 5.9 years, and the mean duration post liver transplant 11.8 +/- 4.5 years. The prevalence of AMD in either eye (grades 2-5) was 52.7% (see figure 1)
Conclusions:
This is the first report of the prevalence of AMD in a liver transplant cohort. AMD seems to be more prevalent in this cohort than in the normal population. This may be the result of systemic illness. Alternately receipt of a liver with varying CFH gene status to that originally in the recipient may influence the risk of developing AMD.
Keywords: age-related macular degeneration