HLA-A, XXXX and HLA-DR matching reduces the rate of @entity2687 .

@entity1 @entity1530 @entity2687 @entity2149
PURPOSE: The purpose of this study is to determine the effectiveness of HLA typing in preventing @entity2687 . METHODS: This retrospective single-center study analyzed 459 consecutive HLA-typed @entity1 who underwent perforating keratoplasty (PKP) between 1983 and 2001. Grafts were postoperatively transparent after donor-recipient selection by @entity2149 typing. @entity1 were divided into a low- and a high-risk group based on their preoperative diagnosis. RESULTS: The estimated 1-, 5- and 10-year graft survival (Kaplan-Meier) was 93, 88 and 67% in low-risk @entity1 and 73, 43 and 38% in high-risk @entity1 . We found a significant correlation between the number of HLA mismatches and the rate of allograft rejections: a donor-recipient match of two or more alleles in @entity2149 reduces the rejection rate by at least 10% in low-risk (10 years after PKP; P<0.04) and 40% in high-risk @entity1 (3 years after PKP; P<0.0001). Especially @entity1530 mismatches are important prognostic factors for both low- ( P<0.008) and high-risk @entity1 ( P<0.003). Considering both @entity1530 mismatches significantly reduces the rate of allograft rejection, particularly in high-risk @entity1 ( P<0.0001). Matching on a split typing level offers no significant advantage over broad level matching. CONCLUSION: Clinical results confirm theories developed to explain the function of the HLA (MHC) receptor. The closest possible donor-recipient match of HLA antigens based on broad level typing significantly reduces the rate of allograft rejection and thus improves the prognosis for long-term transparency of corneal grafts in both high- and low-risk @entity1 .
