Pathophysiology of Corneal Graft Rejection

  • Victor L. Perez
  • William Foulsham
  • Kristen Peterson
  • Reza DanaEmail author


The cornea is the most frequently transplanted tissue in the human body. The primary cause of corneal graft failure is immune rejection, a highly complex sequence of innate and adaptive immune responses that interact to promote tissue destruction. As our understanding of the effector pathways that drive allograft rejection has deepened, so too has our comprehension of the diverse immunoregulatory mechanisms that restrain the effector response and promote graft tolerance. This chapter reviews the incidence, the risk factors and the cellular and molecular mechanisms that underlie corneal allograft rejection. The amalgam of anatomical features, immune cells, and immunoregulatory factors that promote tolerance and immune quiescence are described. Finally, possibilities for future therapeutic approaches to promote graft survival are considered.


Corneal transplantation Allograft rejection Antigen presenting cells Regulatory T cells Immune tolerance 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Victor L. Perez
    • 1
  • William Foulsham
    • 2
  • Kristen Peterson
    • 3
  • Reza Dana
    • 4
    Email author
  1. 1.Duke Eye CenterDepartment of OphthalmologyDurhamUSA
  2. 2.Schepens Eye Research Institute, Massachusetts Eye and Ear InfirmaryDepartment of Ophthalmology, Harvard Medical SchoolBostonUSA
  3. 3.Duke UniversityDepartment of OphthalmologyDurhamUSA
  4. 4.Harvard Medical SchoolCornea & Refractive Surgery, Massachusetts Eye & EarBostonUSA

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