An adverse matching effect for the HLA-B locus in corneal transplantation.

The results of tissue typing on 115 recipient/donor pairs prior to corneal grafting were analyzed with the proportional hazard regression model for the incidence of the first rejection episode and for graft failure from rejection. Like other investigators, we found that a previously failed corneal graft and the degree of recipient corneal vascularization were significant risk factor for graft rejection. ABO blood group matching had no effect. The absence of mismatches in both the HLA-A and HLA-DR loci decreased the incidence of rejection. However, no difference was observed for the presence of one versus two mismatches. Regression results for the HLA-A and DR loci were not significant. Surprisingly, matching for one or both HLA-B alleles resulted in a significantly higher incidence of graft rejection episodes (P < 0.005) and of graft failure (P < 0.052). This adverse matching effect for the B locus was proportional to the number of mismatches.