Association between corneal allograft reactions and HLA compatibility

Ophthalmology. 1990 Dec;97(12):1689-98. doi: 10.1016/s0161-6420(90)32360-6.


The purpose of this follow-up study is to measure the association between corneal allograft reactions and donor-recipient HLA-A and HLA-B compatibility. Four hundred thirty-eight consecutive adult recipients of corneal grafts with known donor-recipient HLA matching were observed for allograft reactions and failures. Most of the recipients under observation (91%) were well matched for HLA-DR. Of 438 recipients, 158 (36%) completed a 3-year follow-up. Three factors were associated with endothelial allograft reactions: 2 to 4+ corneal vascularization (relative risk, 2.2; P = 0.0006), two mismatched antigens at either the HLA-A or HLA-B locus (relative risk, 2.1; P = 0.0009), and recipient wound size of 8 mm or greater (relative risk, 1.5; P = 0.05). Unexpectedly, a strong association between endothelial allograft reactions and HLA-A or HLA-B incompatibility was found in low-risk recipients defined as unvascularized recipients of a small graft (relative risk, 3.2; P = 0.004). A larger sample size is required to determine if HLA matching offers a solution for recipients with corneal vascularization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Clinical Protocols
  • Data Interpretation, Statistical
  • Endothelium, Corneal / immunology
  • Female
  • Follow-Up Studies
  • Graft Survival / immunology
  • HLA-A Antigens / immunology
  • HLA-B Antigens / immunology
  • HLA-DR Antigens / immunology
  • Histocompatibility / immunology*
  • Histocompatibility Testing
  • Humans
  • Keratoplasty, Penetrating / immunology*
  • Male
  • Middle Aged
  • Risk Factors
  • Transplantation, Homologous


  • HLA-A Antigens
  • HLA-B Antigens
  • HLA-DR Antigens