CORNEAL GRAFT REJECTION

Course overview

DESPITE THE RELATIVE IMMUNE PRIVILEGE OF THE CORNEA AS A TRANSPLANTED TISSUE (BOTH THE RECIPIENT CORNEAL BED AND THE ANTERIOR CHAMBER ARE IMMUNE-PRIVILEGED SITES), THE MOST COMMON CAUSE OF CORNEAL GRAFT FAILURE IN ALL REPORTS IS ALLOGENEIC REJECTION. IN FIRST-TIME GRAFT RECIPIENTS WITH NO VASCULARISATION OF THE RECIPIENT'S CORNEAL BED, 2-YEAR SURVIVAL RATES EXCEED 90%; THIS DECREASES TO 35% TO 70% IN RECIPIENTS WITH HIGH-RISK FACTORS FOR REJECTION. IN ONE-THIRD OF ALL CORNEAL GRAFTS FAIL, SIGNS OF A DESTRUCTIVE ATTACK BY THE IMMUNE SYSTEM HAVE BEEN OBSERVED. A REJECTION EPISODE RESULTS IN A LOSS OF DONOR ENDOTHELIAL CELLS, WHICH ARE CRITICAL FOR THE MAINTENANCE OF CORNEAL TRANSPARENCY. THIS ACTIVITY HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR PATIENTS WITH THE CHALLENGE OF CORNEAL GRAFT REJECTION.