Causes of corneal transplant failure: a multicentric study

2021 ◽  
Author(s):  
Alba Gómez‐Benlloch ◽  
Andrea Montesel ◽  
Luis Pareja‐Aricò ◽  
David Mingo‐Botín ◽  
Ralph Michael ◽  
...  
Keyword(s):  
Corneal Transplant ◽  
Multicentric Study ◽  
Transplant Failure

Differential effects of primary disease and corneal vascularisation on corneal transplant rejection and survival

2019 ◽  
Vol 104 (5) ◽  
pp. 729-734 ◽  
Author(s):  
Daniel Sibley ◽  
Cathy L Hopkinson ◽  
Stephen J Tuft ◽  
Stephen B Kaye ◽  
Daniel F P Larkin
Keyword(s):  
Cox Regression ◽  
Transplant Rejection ◽  
Bullous Keratopathy ◽  
Corneal Transplant ◽  
Post Transplant ◽  
Weak Evidence ◽  
Previous Infection ◽  
Transplant Failure ◽  
Clinically Significant ◽  
The Uk

AimsTo investigate the relative risk of pretransplant corneal vascularisation on rate of rejection and graft failure within 5 years of surgery when categorised by indication for transplantation.We analysed all adults recorded in the UK transplant registry who had a first cornea transplant for keratoconus (KC), pseudophakic bullous keratopathy (PBK) or previous infection (viral/bacterial/fungal/protozoan) between 1999 and 2017. We analysed the number of quadrants of the recipient cornea vascularised before transplant and type of vascularisation, the interval post-transplant to rejection, if any, and the outcome at 5 years post-transplant. Risk factors for rejection and transplant failure were modelled by multivariable risk-adjusted Cox regression.ResultsCorneal vascularisation was recorded in 10%, 25% and 67% of patients with KC, PBK and infection, respectively. Individuals with PBK had an increased hazard of transplant rejection only when there were more than two quadrants of vascularisation (HR 1.5, p=0.004) when either superficial and/or deep vascularisation was present (HR 1.3 and 1.4, respectively, p=0.004). Individuals who had a transplant for previous infection had an increased hazard of rejection with four quadrants of vascularisation (HR 1.6, p=0.003). There was no risk-adjusted increase in transplant failure associated with vascularisation in any group. There was weak evidence of reduction in risk of rejection and/or failure associated with lamellar compared with penetrating transplantation in KC and PBK in vascularised recipient corneas.ConclusionVascularisation is a risk factor for corneal allograft rejection within 5 years. The indication for transplantation has a clinically significant effect on the magnitude of this risk.

scholarly journals Lymphatic vessels identified in failed corneal transplants with neovascularisation

2018 ◽  
Vol 103 (3) ◽  
pp. 421-427 ◽  
Author(s):  
Michael Adam Diamond ◽  
Sze Wah Samuel Chan ◽  
Xun Zhou ◽  
Yelena Glinka ◽  
Eileen Girard ◽  
...  
Keyword(s):  
In Situ Hybridisation ◽  
Lymphatic Vessels ◽  
Immunoperoxidase Staining ◽  
Corneal Transplant ◽  
Fluorescence In Situ Hybridisation ◽  
Consistent Finding ◽  
Fish Samples ◽  
Corneal Transplants ◽  
Transplant Failure ◽  
Negative Controls

BackgroundCorneal transplant failure with neovascularisation is a leading indication for full-thickness grafts in patients. Lymphangiogenesis is implicated in the pathology of graft failure, and here we systematically evaluate failed human corneal transplants with neovascularisation for the presence of lymphatic vessels.MethodsNine failed grafts with neovascularisation, based on H&E staining with subsequent immunoperoxidase staining for CD31, a blood vessel marker, were selected. Lymphatics were investigated by immunohistochemical and immunofluorescence approaches using podoplanin as a lymphatic marker. In two of nine cases, fluorescence in situ hybridisation (FISH) was used for detection of lymphatic mRNAs including podoplanin, VEGFR-3 and LYVE-1. All immunofluorescence and FISH samples were compared with positive and negative controls and visualised by confocal microscopy.ResultsCorneal neovascularisation was established in all cases by H&E and further confirmed by CD31 immunoreactive profiles. Immunohistochemistry for the podoplanin antibody was positive in all cases and showed morphologies ranging from distinct luminal structures to elongated profiles. Simultaneous immunofluorescence using CD31 and podoplanin showed lymphatic vessels distinct from blood vessels. Podoplanin immunofluorescence was noted in seven of nine cases and revealed clear lumina of varying sizes, in addition to lumen-like and elongated profiles. The presence of lymphatic mRNA was confirmed by FISH studies using a combination of at least two of podoplanin, VEGFR-3 and LYVE-1 mRNAs.ConclusionsThe consistent finding of lymphatic vessels in failed grafts with neovascularisation implicates them in the pathogenesis of corneal transplant failure, and points to the lymphatics as a potential new therapeutic target.

scholarly journals The Effect of ABO Blood Incompatibility on Corneal Transplant Failure in Conditions with Low-risk of Graft Rejection

2009 ◽  
Vol 147 (3) ◽  
pp. 432-438.e3 ◽  
Author(s):  
Steven P. Dunn ◽  
Walter J. Stark ◽  
R. Doyle Stulting ◽  
Jonathan H. Lass ◽  
Alan Sugar ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Low Risk ◽  
Corneal Transplant ◽  
Transplant Failure

scholarly journals Corneal transplant failure associated with smoking

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Frederick W. Fraunfelder ◽  
Murugesan Raju ◽  
Austin Strohbehn
Keyword(s):  
Corneal Transplant ◽  
Transplant Failure

Prevention of corneal transplant failure

1992 ◽  
Vol 55 ◽  
pp. 178
Author(s):  
D.J. Coster ◽  
K.A. Williams
Keyword(s):  
Corneal Transplant ◽  
Transplant Failure

Abstract #265 Clinical Characteristic of 31 Patients Diagnosed with Latent Autoimmune Diabetes in Adults (Lada) in a Multicentric Study in Mexico

2019 ◽  
Vol 25 ◽  
pp. 103
Author(s):  
Raquel Faradji ◽  
Carmen Castillo-Galindo ◽  
Natalia De la Garza-Hernandez ◽  
Sigfrido Miracle-Lopez ◽  
Claudia Ramirez-Renteria ◽  
...  
Keyword(s):  
Autoimmune Diabetes ◽  
Multicentric Study ◽  
Latent Autoimmune Diabetes ◽  
Clinical Characteristic

Prevalence and determinants of vitamin D deficiency in pregnant women and their neonates: a multicentric study in Switzerland

2017 ◽  
Author(s):  
JP Krieger ◽  
S Cabaset ◽  
A Richard ◽  
L Ganeo-Christoffel ◽  
C Canonica ◽  
...  
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Vitamin D Deficiency ◽  
Multicentric Study

COMPARATIVE ANALYSIS OF CLOSED REDUCTION AND EXPERT TIBIA NAILING WITH OPEN REDUCTION AND PLATE & SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES

2018 ◽  
Author(s):  
Anil Pandey ◽  
Setul Shah ◽  
Deepak S Maravi ◽  
S Uikey
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Proximal Tibia ◽  
Plate Fixation ◽  
Surgical Site Infections ◽  
Delayed Union ◽  
Large Sample Size ◽  
Multicentric Study ◽  
Group A ◽  
Group B

Introduction:- Extra-articular proximal tibial fractures account for 5–10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary  nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and methods:- 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results:- Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:- in treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended   Key words: intramedullary nailing (IMN), Extraarticular tibialn fracture, Surgical site infection.

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