Leukocytes in the Graft Bed Associated with Corneal Graft Failure: Analysis by Immunohistology and Actuarial Graft Survival

Immunohistochemical staining analysis using monoclonal antibodies was performed on 107 recipient corneas removed at graft. There were significantly more infiltrating cells bearing one or more of the leukocyte-common antigen, class II major histocompatibility complex antigens, various myeloidlineage markers, and a peripheral T cell marker, in the graft beds of those recipients who subsequently lost a corneal graft than there were in the graft beds of those for whom the outcome was successful. The hypothesis that large numbers of leukocytes in the recipient graft bed would be correlated with subsequent graft failure was examined by actuarial graft survival analysis. Recipients whose corneas contained fewer than 50 leukocyte-common antigen-positive cells/mm² of corneal stroma showed a 3-year actuarial graft survival of 83%, compared with 39% in those whose corneas contained more than 50 such cells/mm². The corneal leukocyte count was a particularly useful prognostic indicator of outcome in those patients judged clinically to be at risk of graft failure.