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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Mar 24, 2016; 6(1): 10-27
Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.10
Published online Mar 24, 2016. doi: 10.5500/wjt.v6.i1.10
High-risk corneal allografts: A therapeutic challenge
Tian Yu, Vijayalakshmi Rajendran, John V Forrester, Lucia Kuffová, Section of Immunity, Infection and Inflammation, Division of Applied Medicine, School of Medicine and Dentistry, Institute of Medical Sciences, University of Aberdeen, Scotland AB25 2ZD, United Kingdom
May Griffith, Integrative Regenerative Medicine Centre, Department of Clinical and Experimental Medicine, Linköping University, S-58185 Linköping, Sweden
May Griffith, Department of Ophthalmology, Maisonneuve-Rosemont Hospital, Montreal H1T 2M4, Canada
John V Forrester, Ocular Immunology Program, Centre for Ophthalmology and Visual Science, University of Western Australia, Perth WA 6009, Australia
Author contributions: Yu T and Rajendran V contributed equally to this work; Rajendran V and Kuffová L performed the experiments; Yu T and Rajendran V conducted literature review and writing of the manuscript; Griffith M provided intellectual input and critical revision; Forrester JV and Kuffová L provided intellectual input, critical revision and approval of the final version.
Supported by Saving Sight in Grampian, Development Trust of University of Aberdeen, United Kingdom; Action Medical Research United Kingdom (grant SP4328) and Linköping University, Sweden.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lucia Kuffová, MD, PhD, Section of Immunity, Infection and Inflammation, Division of Applied Medicine, School of Medicine and Dentistry, Institute of Medical Sciences, University of Aberdeen, Scotland AB25 2ZD, United Kingdom. l.kuffova@abdn.ac.uk
Telephone: +44-012-24437505 Fax: +44-012-24437506
Received: July 30, 2015
Peer-review started: August 5, 2015
First decision: September 21, 2015
Revised: November 4, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: March 24, 2016
Peer-review started: August 5, 2015
First decision: September 21, 2015
Revised: November 4, 2015
Accepted: December 3, 2015
Article in press: December 4, 2015
Published online: March 24, 2016
Core Tip
Core tip: Corneal grafts enjoy a high acceptance rate when performed in “low-risk” host graft beds. This is associated with a relatively weak alloimmune response. However, in “high-risk” hosts where the immunologically quiescent homeostatic environment of the cornea is compromised prior to graft procedure, heightened immune responses significantly increase the risk of graft rejection. Clinical approaches such as tissue matching and long-term immunosuppression could be beneficial in preventing graft rejection especially in “high-risk” settings. In addition, promotion of transplant tolerance by cell-based therapies and use of corneal “substitutes” such as collagen-based hydrogels are promising alternatives for “high-risk” recipients.