PMID- 10201609
OWN - NLM
STAT- MEDLINE
DCOM- 19990415
LR  - 20061115
IS  - 0161-6420 (Print)
IS  - 0161-6420 (Linking)
VI  - 106
IP  - 4
DP  - 1999 Apr
TI  - Limbal allografting from related live donors for corneal surface reconstruction.
PG  - 822-8
AB  - OBJECTIVE: To report the results of limbal allograft transplantation, from human 
      leukocyte antigen (HLA)-matched and -unmatched related live donors, in patients 
      with ocular surface disease due to chemical burns and Stevens-Johnson syndrome. 
      DESIGN: Retrospective, noncomparative case series. PARTICIPANTS: Eight patients 
      (nine eyes) with severe chemical burns (n = 7 eyes) and Stevens-Johnson syndrome 
      (n = 2 eyes). INTERVENTION: Recipient eyes were treated with excision of 
      cicatricial tissues. Transplantation of superior and inferior limbal grafts was 
      performed from related live HLA-matched (n = 7) and -unmatched donors (n = 2). 
      Systemic cyclosporine was not used in any of the recipients. MAIN OUTCOME 
      MEASURES: Reconstruction of corneal surface epithelium, restoration of 
      avascularity, increase in ocular comfort, and improvement in visual acuity. 
      RESULTS: With a mean observation period of 17.2 months, phenotypically corneal 
      epithelium, decreased vascularization of the corneal surface, and improved ocular 
      comfort were seen in seven (77.8%) eyes. In all seven eyes, gradual recurrence of 
      peripheral corneal vascularization occurred during the follow-up period. Features 
      of graft rejection developed in three (42.9%) of these seven eyes. In two eyes, 
      limbal transplantation from HLA-unmatched donors failed to reconstitute the 
      corneal surface. Limbal allograft transplantation resulted in visual acuity of 
      20/400 or greater in only two (22.2%) eyes at last follow-up. Corneal grafts 
      performed 7 and 16 months after successful limbal transplantation in two eyes 
      developed recurrent epithelial breakdown and superficial corneal scarring. None 
      of the donor eyes in this study had any complication. CONCLUSION: Transplantation 
      of limbal tissue from related live donors successfully reconstructs the corneal 
      surface in HLA-matched recipients. Recurrence of vascularization on long-term 
      follow-up probably results from inadequate stem cell transfer, immune-mediated 
      stem cell damage, or both. Limbal allografting is best performed by transplanting 
      the entire limbus from a cadaveric donor eye with systemic immunosuppression of 
      the recipient, even if the donor is HLA-compatible.
FAU - Rao, S K
AU  - Rao SK
AD  - Cornea Service, Sankara Nethralaya, Medical Research Foundation, Chennai, India.
FAU - Rajagopal, R
AU  - Rajagopal R
FAU - Sitalakshmi, G
AU  - Sitalakshmi G
FAU - Padmanabhan, P
AU  - Padmanabhan P
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
SB  - IM
CIN - Ophthalmology. 2000 Mar;107(3):411-2. PMID: 10711872
MH  - Adolescent
MH  - Adult
MH  - *Cell Transplantation
MH  - Child
MH  - Corneal Diseases/pathology/*surgery
MH  - Epithelium, Corneal/*cytology
MH  - Female
MH  - Histocompatibility Testing
MH  - Humans
MH  - Limbus Corneae/*cytology
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Visual Acuity
MH  - Wound Healing
EDAT- 1999/04/14 00:00
MHDA- 1999/04/14 00:01
CRDT- 1999/04/14 00:00
PHST- 1999/04/14 00:00 [pubmed]
PHST- 1999/04/14 00:01 [medline]
PHST- 1999/04/14 00:00 [entrez]
AID - S0161-6420(99)90173-2 [pii]
AID - 10.1016/S0161-6420(99)90173-2 [doi]
PST - ppublish
SO  - Ophthalmology. 1999 Apr;106(4):822-8. doi: 10.1016/S0161-6420(99)90173-2.