Four corneas from two cadavers that later had positive test results on enzyme-linked immunosorbent assays and Western blot analysis for antibodies against the human immunodeficiency virus were inadvertently transplanted to recipients who were without known risk of human immunodeficiency virus infection. We performed serial studies of serologic markers of human immunodeficiency virus infection in the cornea recipients and assayed reverse transcriptase levels of their mixed lymphocyte cultures. The four cornea transplant recipients were followed up for 130, 152, 397, and 440 days, respectively, and the results on all serologic tests and reverse transcriptase assays remain negative.
"Since the first successful penetrating keratoplasty (PKP) was reported by Edward Zirm in 1906, corneal transplant has become the oldest, most successful and most common form of tissue transplantation (Pepose et al., 1987). The success rate for maintaining a clear transplant has increased over the years (Price and Whitson, 1991; Williams et al., 2006). "
[Show abstract][Hide abstract] ABSTRACT: There is scarcity of data in the literature on cornel graft rejection rate in patients exclusively of African ancestry. The purpose of this study was to evaluate the rejection rate of corneal transplant surgery performed at Howard University Hospital on such patients over a 15 year period.
A retrospective evaluation was performed of the cornea graft rejection and corneal graft failure rate in 125 penetrating keratoplasties (PKPs) done by one corneal specialist at Howard University Hospital from January 1, 1990 to August 31, 2005.
Of the 125 patients, 62 were eliminated from the study because of re-grafted eyes, non-African descent, primary graft failures, follow-up less than 1 month and lack of availability of charts. This study, therefore, studied and recorded data from 63 penetrating keratoplasties of 63 eyes from 60 patients.
Episodes of graft rejection were documented in 23 eyes (36.5% of cases). Nine out of the 23 graft rejections manifested to secondary graft failure (39%). Overall, there were nine out of the 63 PKPs (14.3%) that resulted in secondary graft failure over the past 15 years. The major diagnostic categories were bullous keratopathy 24 (38%), keratoconus 10 (15.8%), Fuch's dystrophy 4 (6.3%), other 20 (31.7%). Of the cases with episodes of rejection and failure, 4.3% and none were attributable to keratoconus, 30.4% and 22.2% for bullous keratopathy, and 8.7% and 22.2% for Fuch's dystrophy, respectively. Also, best visual acuity was looked at in patients with rejection episodes. None of the patients had a pre-op visual acuity 20/40 or better; however, post-op PKP 2 (8.7%) of patients achieved 20/40 or better. Also, 4 (17.4%) of patients had a pre-op visual acuity between 20/50 and 20/150, but post-op PKP best visual acuity between 20/50 and 20/150 was increased to 9 (39.1%).
At 36% the prevalence of corneal graft rejection was one of the highest in the reported literature. But only 14% of those episodes resulted in graft failure which is one of the lowest in the published literature. This study demonstrates that patients of African ancestry may have a higher rejection rate which does not necessarily result in graft failure.
Saudi Journal of Ophthalmology 07/2011; 25(3):285-9. DOI:10.1016/j.sjopt.2011.04.007
[Show abstract][Hide abstract] ABSTRACT: Forty eye banks responded to an Eye Bank Association of America (EBAA) questionnaire concerning screening patients at risk for acquired immune deficiency syndrome (AIDS) and hepatitis B. Respondents accounted for 26% (8787 of 33,500) of the total volume of eyes donated in North America in 1986. Sixty (0.68%) of 8787 donors were found to be antibody positive for human immunodeficiency virus (HIV) and 69 (1.33%) of 5187 donors were found to be positive for hepatitis B virus (HBV). The age, cause of death, and source of tissue were also studied. The finding of seropositivity for HIV in very young and elderly donors without identified risk factors underscores the need to screen all potential cornea donors for the presence of HIV antibodies. The data on HBV lend further support to the importance of such screening procedures.
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