PMID- 11150276
OWN - NLM
STAT- MEDLINE
DCOM- 20010201
LR  - 20190726
IS  - 0161-6420 (Print)
IS  - 0161-6420 (Linking)
VI  - 108
IP  - 1
DP  - 2001 Jan
TI  - Living related conjunctival limbal allograft for the treatment of stem cell 
      deficiency.
PG  - 126-33; discussion 133-4
AB  - PURPOSE: To evaluate the outcomes of living related conjunctival limbal allograft 
      transplantation for the treatment of stem cell deficiency. DESIGN: Retrospective, 
      noncomparative case series. PARTICIPANTS: Nine living related donors, eight 
      recipients (10 eyes) with Stevens-Johnson syndrome (3 eyes), ectodermal dysplasia 
      (3 eyes), chemical injury (2 eyes), ocular cicatricial pemphigoid (1 eye), and 
      atopic keratoconjunctivitis (n = 1). INTERVENTION: Four clock hours of limbal 
      conjunctival tissue from the best matched human leukocyte antigen (HLA) relative 
      donor were transplanted to the recipient eye superiorly and inferiorly after 
      conjunctival peritomy and removal of conjunctival pannus. Systemic cyclosporine 
      was administered to all recipients. MAIN OUTCOME MEASURES: Restoration of corneal 
      epithelium, reduction of vascularity and conjunctivalization, improved comfort, 
      improved corneal clarity, and visual improvement. RESULTS: Mean follow-up period 
      was 26.2 months. Two highly inflamed eyes failed to initially epithelialize. The 
      remainder all survived with restoration of corneal epithelium and reduction of 
      vascularization. Corneal opacification was reduced (four of eight eyes) and 
      visual improvement was achieved in seven eyes. All five eyes with pain had an 
      improvement in symptoms. Allograft rejection occurred in two eyes (25%), and both 
      were treated successfully. Both eyes had two class I HLA mismatches, and both had 
      an underlying diagnosis of Stevens-Johnson syndrome. One eye developed a 
      recurrent epithelial defect and perforated, requiring a penetrating keratoplasty 
      that remained clear with an intact epithelial surface. The two initial failures 
      also perforated and required penetrating keratoplasties that failed. None of the 
      donor eyes had any complications. CONCLUSIONS: Restoration of the ocular surface 
      by HLA-matched conjunctival limbal allograft transplantation can be accomplished 
      in selected recipients. Systemic cyclosporine, even at low doses, is useful in 
      ensuring long-term survival.
FAU - Daya, S M
AU  - Daya SM
AD  - Corneo Plastic Unit & Eye Bank, Queen Victoria Hospital, East Grinstead, West 
      Sussex, England RH19 3DZ, UK.
FAU - Ilari, F A
AU  - Ilari FA
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Ophthalmology
JT  - Ophthalmology
JID - 7802443
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Blood Grouping and Crossmatching
MH  - *Cell Transplantation
MH  - Conjunctiva/*cytology
MH  - Corneal Diseases/pathology/*surgery
MH  - Epithelial Cells/*transplantation
MH  - Epithelium, Corneal/pathology/*surgery
MH  - Female
MH  - Graft Survival
MH  - Histocompatibility Testing
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - *Living Donors
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - *Stem Cell Transplantation
MH  - Transplantation, Homologous
MH  - Treatment Outcome
MH  - Visual Acuity
EDAT- 2001/01/11 11:00
MHDA- 2001/02/28 10:01
CRDT- 2001/01/11 11:00
PHST- 2001/01/11 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2001/01/11 11:00 [entrez]
AID - S0161-6420(00)00475-9 [pii]
AID - 10.1016/s0161-6420(00)00475-9 [doi]
PST - ppublish
SO  - Ophthalmology. 2001 Jan;108(1):126-33; discussion 133-4. doi: 
      10.1016/s0161-6420(00)00475-9.