[Differential effect of incompatibilities of the HLA-A and HLA-B locus on the success of corneal transplants].

The positive influence of HLA-compatible donor material on successful transplantation was proven especially for prognostically unfavourable cases. Nevertheless it is not clear whether varying importance should be attached to the antigen incompatibilities at the HLA-A and HLA-B locus. 62 keratoplasty patients, 37 of whom had primarily poor prognoses and 25 patients with low risk of transplant rejection were prospectively given transplants in which more than two certain incompatibilities at the HLA-A and HLA-B locus had been ruled out. The number of Ag incompatibilities (separately according to locus) was related retrospectively to postoperative progress. An irreversible transplant failure had occurred in 6 patients (16%) four months after surgery in the high-risk group, whereas 31 transplants (84%) remained clear. The course of healing was without complications within the first four months in all patients with favourable starting position. The influence of the HLA disparities on transplantation success was examined by means of the chi-square test. Taking the Ag incompatibilities of both loci in combination into account showed an only marginally significant (p = 0.1) influence on the survival rate of the transplant. Here HLA-A incompatibilities appear to have only secondary significance, whereas incompatibilities at the HLA-B locus correlated inversely (p = 0.02) with the success of transplantation.