Document Detail


Individual analysis of expected time on the waiting list for HLA-matched corneal grafts.
MedLine Citation:
PMID:  12494680     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Recent studies report the beneficial effect of HLA matching for long-term prognosis of penetrating keratoplasty (kp). This improvement of prognosis, however, has to be weighed against the additional time on the waiting list due to the search for a HLA-compatible graft. Reliable estimation of this additional waiting period is a prerequisite for informed consent on the waiting policy. METHODS: A mathematical model based on survival analysis and HLA haplotype frequencies was used to estimate time on the waiting list for each of 1,400 HLA-typed patients registered at the Lions Cornea Bank NRW. Additionally, the waiting period of each patient was retrospectively determined. Both values were tested for correlation. This analysis was performed for acceptance of up to two mismatches on HLA-A, -B and -DR. RESULTS: When accepting two, one and zero mismatches, median predicted waiting period was 1 +/- 6, 7 +/- 49 and 17 +/- 159 months respectively. Median waiting period in retrospective simulation was 1 +/- 3, 5 +/- 9 and 15 +/- 14 months. Correlation of values from the predictive formula and simulation was statistically significant (p < 0.0001). CONCLUSION: Predicted time on the waiting list is a valuable tool for management of HLA matching in kp.
Authors:
D Böhringer; T Reinhard; J Enczmann; E Godehard; R Sundmacher
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Developments in ophthalmology     Volume:  36     ISSN:  0250-3751     ISO Abbreviation:  Dev Ophthalmol     Publication Date:  2003  
Date Detail:
Created Date:  2002-12-23     Completed Date:  2003-01-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8010321     Medline TA:  Dev Ophthalmol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  50-5     Citation Subset:  IM    
Affiliation:
Eye Hospital and Lions Cornea Bank North Rhine-Westphalia, University Hospital Heinrich Heine University, Düsseldorf, Germany. daniel.boehringer@uni-duesseldorf.de
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MeSH Terms
Descriptor/Qualifier:
Cornea / immunology*
Graft Survival / physiology
Histocompatibility Antigens Class I / immunology*
Histocompatibility Antigens Class II / immunology*
Histocompatibility Testing
Humans
Keratoplasty, Penetrating / immunology*
Models, Biological
Models, Theoretical
Time Factors
Tissue Donors
Waiting Lists*
Chemical
Reg. No./Substance:
0/Histocompatibility Antigens Class I; 0/Histocompatibility Antigens Class II

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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