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Best Survival of Corneal Retransplantation Using Systemic Immunossupression

  • Maria Cristina Ribeiro de Castro
  • Tadeu Cvintal
Part of the Transplantation and Clinical Immunology book series (TRAC, volume 29)

Abstract

In all domains of organ transplantation, retransplants are a major immunological concern. First corneal grafts are usually not rejected, but further grafts show the same rate of rejection than solid organs. In our experience 50% of corneal retransplants have never attained good function. With the aim to improve corneal retransplants survival and function, 18 patients received a corneal retransplant using immunossupression. Ten patients were female, median age was 58 years old (ranging from 25 to 81 years old), the majority received a secondary graft. Thirteen received triple therapy (cyclosporin A: 5 mg/kg/day; azathioprine: 2 mg/kg/day; prednisone: 1 mg/kg/day, as initial doses from the day of grafting), and 5 received no prednisone because of concurrent diseases or advanced age. Severe clinical assessment, performed before surgery, and a frequent clinical surveillance posttransplantation avoided major complications. Reactivity against T lymphocytes was tested by a panel reactivity assay (PRA) in 8 patients and was positive in only one (13% of reactivity). One year follow-up shows 77% of patients with good function and no rejection. Fifteen percent of them lost the graft because of non-immunological problems, mainly glaucoma. Only 1 patient has lost the graft because of rejection, probably due to non-compliance. One patient presented one episode of hypertensive emergency and hypervolemia, due to the unintentional association of cyclosporine and a non-steroid anti-inflammatory drug, promptly reversed with the withdrawal of the second one. There was one bacterial pneumonic process in a diabetic patient, one episode of gastritis, one Herpes zoster infection and 2 mild rises in liver enzymes.

Keywords

Diabetic Patient Major Complication Liver Enzyme Good Selection Organ Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Copyright information

© Kluwer Academic Publishers 1997

Authors and Affiliations

  • Maria Cristina Ribeiro de Castro
    • 1
  • Tadeu Cvintal
    • 1
  1. 1.Instituto Tadeu Cvintal de OftalmologiaSão PauloBrasil

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