The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Doyle R Stulting - One of the best experts on this subject based on the ideXlab platform.
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factors associated with Graft Rejection in the cornea preservation time study
American Journal of Ophthalmology, 2018Co-Authors: Doyle R Stulting, Jonathan H Lass, Mark A Terry, Beth Ann Benetz, Nathan J Cohen, Allison R Ayala, Maureen G Maguire, Christopher R Croasdale, Yassine J Daoud, Steven P DunnAbstract:Purpose To identify factors related to Graft Rejection following Descemet stripping automated endothelial keratoplasty (DSAEK) in the Cornea Preservation Time Study (CPTS). Design Cohort study within a multicenter randomized clinical trial. Methods A total of 1330 eyes of 1090 subjects undergoing DSAEK were randomized to receive a donor cornea with preservation time (PT) of 0–7 days (n = 675) or 8–14 days (n = 655) and followed for 3 years. Central endothelial cell density (ECD) was determined by a central image analysis reading center. Multivariable Cox models adjusted for PT, recipient diagnosis, and surgeon effect were used to identify factors associated with Rejection. Results Cumulative probability of definite Graft Rejection was 3.6% (99% confidence interval 2.5%–5.3%). Younger recipient age was associated with Graft Rejection (P .01). Among clear Grafts with an ECD measurement at baseline and 3 years (n = 913), endothelial cell loss (ECL) was greater in eyes that experienced a Rejection episode (n = 27) than in those that did not (n = 886) (48% vs 38%, P = .03). Twelve of 44 eyes (27%) with definite Graft Rejection subsequently failed, comprising 15% of the 79 failures in the CPTS. Conclusions Graft Rejection is uncommon after DSAEK and more likely with younger age, in a study cohort mostly > 50 years old. Rejection increases ECL, but it is not a leading cause of DSAEK failure.
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prevention and treatment of corneal Graft Rejection current practice patterns 2004
Cornea, 2006Co-Authors: Bradley J Randleman, Doyle R StultingAbstract:Purpose:This study was designed to analyze current practice patterns in the prevention and treatment of corneal Graft Rejection and to compare these patterns with previously reported practices.Methods:In January 2004, a survey addressing the routine postoperative management of corneal transplants an
John A Seedor - One of the best experts on this subject based on the ideXlab platform.
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Graft Rejection following descemet stripping automated endothelial keratoplasty features risk factors and outcomes
American Journal of Ophthalmology, 2012Co-Authors: Elaine I Wu, David C Ritterband, Guopei Yu, Rebecca A Shields, John A SeedorAbstract:PURPOSE: To investigate the clinical features, risk factors, and treatment outcomes following immunologic Graft Rejection in eyes that have undergone Descemet stripping automated endothelial keratoplasty (DSAEK). DESIGN: Retrospective case review. METHODS: The charts for 353 DSAEK procedures performed at a single clinical practice at the New York Eye and Ear Infirmary from August 2006 to November 2010 were reviewed. Cases with at least 3 months follow-up were included. Outcome measures included rates of Graft Rejection, clinical findings, treatment outcomes, and risk factor analysis. RESULTS: Thirty of 353 DSAEKs developed Graft Rejection (8.5%). Kaplan-Meier rate of Rejection was 6.0% at 1 year (n = 175), 14.0% at 2 years (n = 79), and 22.0% at 3 years (n = 39). Rejection episodes occurred between 0.8 and 34 months. Clinical findings included anterior chamber cells, keratic precipitates, endothelial Rejection line, and host-donor interface vascularization. Risk factors for development of Graft Rejection were cessation of postoperative steroid (hazard ratio 5.49, P < .0001) and black race (hazard ratio 2.71, P = .02). Recipient age, sex, surgical indication, glaucoma, postoperative steroid response, corneal neovascularization or peripheral anterior synechiae, Graft size, prior keratoplasty in fellow eye, and concurrent or subsequent procedures were not associated with Graft Rejection. Twenty-two out of 30 Rejection episodes (73.3%) resolved with steroid treatment. CONCLUSIONS: Graft Rejection is an important complication following DSAEK. In contrast to penetrating keratoplasty, Rejection following DSAEK is almost exclusively endothelial. Among risk factors traditionally associated with Graft Rejection, cessation of topical steroids was most significant. Prompt recognition and treatment of DSAEK Rejection can lead to favorable outcomes.
David Davisboozer - One of the best experts on this subject based on the ideXlab platform.
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Graft Rejection after descemet s stripping automated endothelial keratoplasty Graft survival and endothelial cell loss
Ophthalmology, 2012Co-Authors: Jennifer Y Li, Mark A Terry, Jeffrey M Goshe, Neda Shamie, David DavisboozerAbstract:Purpose To evaluate the effects of Graft Rejection episodes after Descemet's stripping automated endothelial keratoplasty surgery (DSAEK) on long-term endothelial cell density (ECD) decline and Graft survival. Design Retrospective, comparative analysis of an interventional case series. Participants We included 615 eyes of 415 Fuchs' dystrophy patients at a single institution with ≥6 months follow-up and without comorbidities known to influence postoperative ECD. All patients were enrolled as part of an ongoing, institutional review board-approved clinical protocol for a long-term, prospective study of endothelial keratoplasty in patients with endothelial dysfunction. Methods Preoperative specular microscopy of donor corneal tissue was performed. Postoperative specular microscopy measurements were recorded at 6 and 12 months, and yearly thereafter. The percentages of endothelial cell loss recorded at 1, 2, 3, and 4 years were compared with the Mann–Whitney U test. Main Outcome Measures Percentage ECD declines were calculated at each time point from the results of the preoperative and postoperative specular microscopy. Patients with Graft Rejection episodes and late endothelial failure were identified. Graft Rejection was defined as findings of keratic precipitates with or without corneal edema, or anterior chamber cell and flare with or without corneal edema after the initial resolution of perioperative inflammation. Results We identified 45 cases of Graft Rejection. The greatest number of Rejections occurred between postoperative months 12 and 18. Eyes with a Graft Rejection episode had a higher median percentage decline in ECD at all time points compared with eyes without Graft Rejection episodes. This was statistically significant at 2 and 3 years postoperatively. Conclusions There is a trend toward a greater percentage of ECD loss with time in eyes experiencing Graft Rejection after DSAEK surgery. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
Hugo W Tilanus - One of the best experts on this subject based on the ideXlab platform.
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cytokine gene polymorphisms and acute liver Graft Rejection a meta analysis
Liver Transplantation, 2005Co-Authors: Michiel C. Warlé, Herold J Metselaar, Hugo W TilanusAbstract:In the field of liver transplantation, 7 reports have been published investigating the association between polymorphisms in cytokine genes and the occurrence of acute Rejection in liver Graft recipients. However, most of the individual studies lack the statistical power to detect a small-to-moderate effect of cytokine gene polymorphisms on the acute Rejection rate. To overcome this problem, we performed a quantitative meta-analysis of 7 gene-association studies that were comparable with regard to definition of acute Rejection and the type of immunosuppression used. In the overall analysis, the interleukin (IL)-10 polymorphism at position −1082 was identified as a genetic risk factor for acute liver Graft Rejection; liver transplant recipients carrying the IL-10 −1082.A allele displayed a lower Rejection rate (common odds ratio [OR], .6; 95% confidence interval [CI], .4-.9). For the tumor necrosis factor (TNF)-A −308 polymorphism, a common OR could not be calculated due to significant heterogeneity of ORs between the studies (mean OR, 1.4; 95% CI, .8-2.6). No associations were found between acute liver Graft Rejection and single nucleotide polymorphisms in the IL-6 (position −174) and transforming growth factor (TGF)-β1 (positions +869 and +915) genes. In conclusion, results from this meta-analysis suggest a role for the IL-10 −1082 polymorphism in human liver Graft Rejection. (Liver Transpl 2005;11:19–26.)
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Cytokine gene polymorphisms and acute liver Graft Rejection: A meta‐analysis
Liver Transplantation, 2004Co-Authors: Michiel C. Warlé, Herold J Metselaar, Hugo W TilanusAbstract:In the field of liver transplantation, 7 reports have been published investigating the association between polymorphisms in cytokine genes and the occurrence of acute Rejection in liver Graft recipients. However, most of the individual studies lack the statistical power to detect a small-to-moderate effect of cytokine gene polymorphisms on the acute Rejection rate. To overcome this problem, we performed a quantitative meta-analysis of 7 gene-association studies that were comparable with regard to definition of acute Rejection and the type of immunosuppression used. In the overall analysis, the interleukin (IL)-10 polymorphism at position −1082 was identified as a genetic risk factor for acute liver Graft Rejection; liver transplant recipients carrying the IL-10 −1082.A allele displayed a lower Rejection rate (common odds ratio [OR], .6; 95% confidence interval [CI], .4-.9). For the tumor necrosis factor (TNF)-A −308 polymorphism, a common OR could not be calculated due to significant heterogeneity of ORs between the studies (mean OR, 1.4; 95% CI, .8-2.6). No associations were found between acute liver Graft Rejection and single nucleotide polymorphisms in the IL-6 (position −174) and transforming growth factor (TGF)-β1 (positions +869 and +915) genes. In conclusion, results from this meta-analysis suggest a role for the IL-10 −1082 polymorphism in human liver Graft Rejection. (Liver Transpl 2005;11:19–26.)
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cytokine gene polymorphisms and acute human liver Graft Rejection
Liver Transplantation, 2002Co-Authors: Michiel C. Warlé, Ayar Farhan, Chris Perrey, Pieter E Zondervan, Sjoerd De Rave, Jaap Kwekkeboom, Hugo W Tilanus, Herold J Metselaar, Jan N. M. Ijzermans, Vera PravicaAbstract:Interindividual differences exist in the capacity to produce cytokines. It has been reported that levels of in vitro cytokine production measured after stimulated cell culture are associated with polymorphisms in cytokine genes. Moreover, a correlation between heart, kidney, liver, and lung Graft Rejection or survival with cytokine gene polymorphisms has been described. In the present study, we analyzed the association of gene polymorphisms in T helper subtype 1 (TH1-), TH2-, and regulatory-type cytokines with human liver alloGraft Rejection. Patients who received a primary liver Graft from 1992 onward and were seen at the transplant outpatient clinic since then were included on this study (n = 89). Patients were HLA typed routinely. Biopsy-proven acute Rejection occurred in 41 of 89 patients. After informed consent, blood was collected and DNA was obtained. Using amplification-refractory mutation system polymerase chain reaction, the following cytokine gene polymorphisms were determined: IL-2+166, IL-2-330, IL-15+13689, IL-15-80, TNF-A-308, TNFd3, IFN-G+874 (TH1-type cytokines), IL-4+33, IL-4-590, IL-6-174, IL-10-592, IL-10-819, IL-10-1082, IL-13+2043, IL-13-1055 (TH2 type cytokines), TGF-B1+869, and TGF-B1+915 (regulatory-type cytokines). Univariate analysis showed that polymorphisms of IL-10-1082, TGF-B1+869, and HLA-DR6 were significantly related to liver Graft Rejection. Multiple logistic regression analysis was used to assess which variables remained significantly predictive of acute Rejection. Multivariate analysis showed that TGF-B1+869 and HLA-DR6 were independently associated with the occurrence of acute Rejection. These findings suggest a role for the regulatory-type cytokine transforming growth factor-β1 in human liver Graft Rejection.
Mark A Terry - One of the best experts on this subject based on the ideXlab platform.
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factors associated with Graft Rejection in the cornea preservation time study
American Journal of Ophthalmology, 2018Co-Authors: Doyle R Stulting, Jonathan H Lass, Mark A Terry, Beth Ann Benetz, Nathan J Cohen, Allison R Ayala, Maureen G Maguire, Christopher R Croasdale, Yassine J Daoud, Steven P DunnAbstract:Purpose To identify factors related to Graft Rejection following Descemet stripping automated endothelial keratoplasty (DSAEK) in the Cornea Preservation Time Study (CPTS). Design Cohort study within a multicenter randomized clinical trial. Methods A total of 1330 eyes of 1090 subjects undergoing DSAEK were randomized to receive a donor cornea with preservation time (PT) of 0–7 days (n = 675) or 8–14 days (n = 655) and followed for 3 years. Central endothelial cell density (ECD) was determined by a central image analysis reading center. Multivariable Cox models adjusted for PT, recipient diagnosis, and surgeon effect were used to identify factors associated with Rejection. Results Cumulative probability of definite Graft Rejection was 3.6% (99% confidence interval 2.5%–5.3%). Younger recipient age was associated with Graft Rejection (P .01). Among clear Grafts with an ECD measurement at baseline and 3 years (n = 913), endothelial cell loss (ECL) was greater in eyes that experienced a Rejection episode (n = 27) than in those that did not (n = 886) (48% vs 38%, P = .03). Twelve of 44 eyes (27%) with definite Graft Rejection subsequently failed, comprising 15% of the 79 failures in the CPTS. Conclusions Graft Rejection is uncommon after DSAEK and more likely with younger age, in a study cohort mostly > 50 years old. Rejection increases ECL, but it is not a leading cause of DSAEK failure.
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Graft Rejection after descemet s stripping automated endothelial keratoplasty Graft survival and endothelial cell loss
Ophthalmology, 2012Co-Authors: Jennifer Y Li, Mark A Terry, Jeffrey M Goshe, Neda Shamie, David DavisboozerAbstract:Purpose To evaluate the effects of Graft Rejection episodes after Descemet's stripping automated endothelial keratoplasty surgery (DSAEK) on long-term endothelial cell density (ECD) decline and Graft survival. Design Retrospective, comparative analysis of an interventional case series. Participants We included 615 eyes of 415 Fuchs' dystrophy patients at a single institution with ≥6 months follow-up and without comorbidities known to influence postoperative ECD. All patients were enrolled as part of an ongoing, institutional review board-approved clinical protocol for a long-term, prospective study of endothelial keratoplasty in patients with endothelial dysfunction. Methods Preoperative specular microscopy of donor corneal tissue was performed. Postoperative specular microscopy measurements were recorded at 6 and 12 months, and yearly thereafter. The percentages of endothelial cell loss recorded at 1, 2, 3, and 4 years were compared with the Mann–Whitney U test. Main Outcome Measures Percentage ECD declines were calculated at each time point from the results of the preoperative and postoperative specular microscopy. Patients with Graft Rejection episodes and late endothelial failure were identified. Graft Rejection was defined as findings of keratic precipitates with or without corneal edema, or anterior chamber cell and flare with or without corneal edema after the initial resolution of perioperative inflammation. Results We identified 45 cases of Graft Rejection. The greatest number of Rejections occurred between postoperative months 12 and 18. Eyes with a Graft Rejection episode had a higher median percentage decline in ECD at all time points compared with eyes without Graft Rejection episodes. This was statistically significant at 2 and 3 years postoperatively. Conclusions There is a trend toward a greater percentage of ECD loss with time in eyes experiencing Graft Rejection after DSAEK surgery. Financial Disclosure(s) Proprietary or commercial disclosure may be found after the references.
