DNA Fingerprint Analysis of Donor Cell Survival in Failed Corneal Transplants

Abstract

Abstract: : Purpose: Donor cell survival and replacement by recipient cells in corneal transplants may be important factors in the pathogenesis of corneal transplant failure. Therefore we evaluated donor cell survival and replacement in failed corneal grafts by using DNA fingerprint analysis. Methods: We analyzed 12 corneal grafts after explantation following transplant failure. Corneal transplants survived between five months and 18 years and were grafted in eyes with different primary corneal diseases: infectious ulcer (n=1), herpes keratitis (n=1), scaring (n=1), keratoconus (n=3) and Fuchs` endothelial dystrophy (n=6). We used DNA fingerprint analysis after PCR of simple tandem repeats (STR) to determine the origin of epithelial cells, keratocytes and endothelial cells in explanted grafts. Blood probes of the recipients served as the reference DNA for determining recipient STR-alleles. Results: Donor epithelial cells and keratocytes were constantly replaced by recipient cells over time but in some cases were still detectable up to 6 years after keratoplasty. DNA from endothelial cells was not available for some explants due to endothelial loss, however, in those explants for which DNA was available, donor endothelial cell replacement had also occurred. Conclusions: Donor epithelial cells, keratocytes and endothelial cells are replaced by recipient cells in failed keratoplasties over time. However, endothelial loss, in particular, seems to be critical for graft failure in the majority of corneal transplants.

Keywords: cornea: clinical science • transplantation