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dc.contributor.authorEslani, M.
dc.contributor.authorHaq, Z.
dc.contributor.authorMovahedan, A.
dc.contributor.authorMoss, A.
dc.contributor.authorBaradaran-Rafii, A.
dc.contributor.authorMogilishetty, G.
dc.contributor.authorHolland, E.J.
dc.contributor.authorDjalilian, A.R.
dc.date.accessioned2017-06-27T19:08:15Z
dc.date.available2018-01-15T10:30:06Z
dc.date.issued2017-01-01
dc.identifier.bibliographicCitationEslani, M., Haq, Z., Movahedan, A., Moss, A., Baradaran-Rafii, A., Mogilishetty, G., Holland, E. J. and Djalilian, A. R. Late Acute Rejection After Allograft Limbal Stem Cell Transplantation: Evidence for Long-Term Donor Survival. Cornea. 2017. 36(1): 26-31. DOI: 10.1097/ico.0000000000000970.en_US
dc.identifier.issn0277-3740
dc.identifier.urihttp://hdl.handle.net/10027/21712
dc.descriptionhis is a non-final version of an article published in final form in Eslani, M., Haq, Z., Movahedan, A., Moss, A., Baradaran-Rafii, A., Mogilishetty, G., Holland, E. J. and Djalilian, A. R. Late Acute Rejection After Allograft Limbal Stem Cell Transplantation: Evidence for Long-Term Donor Survival. Cornea. 2017. 36(1): 26-31. DOI: 10.1097/ico.0000000000000970.en_US
dc.description.abstractPurpose: To describe the clinical presentation and management of late (>3.0 years) acute graft rejection in keratolimbal allograft (KLAL) recipients. Methods: This was a multicenter, retrospective observational case series. Six eyes of 6 patients with ocular surface transplant at a mean age of 36.2 years were seen at 3 tertiary referral centers for acute graft rejection between 2007 and 2013. Main outcome measures included strength of systemic immunosuppression (SI) at the time of rejection, time to rejection, and clinical presentation of rejection. Results: Preoperative diagnoses included total limbal stem cell deficiency because of aniridia (n = 2) or chemical injury (n = 4). After an initially successful outcome, patients experienced late acute graft rejection at a mean time of 67.8 ± 24.1 months (range: 41-98) after KLAL while receiving suboptimal levels of SI because of medication taper (n = 5) or noncompliance (n = 1). Objective findings included an epithelial rejection line (n = 6), edema (n = 2), corneal epithelial irregularities (n = 2), and neovascularization (n = 1). Antirejection management consisted of topical corticosteroids (n = 6) and augmentation of SI therapy (n = 5). Conclusions: These cases of late acute graft rejection in KLAL patients support the notion that allodonor cells can persist over the long run and remain at risk for immunologic rejection. It further underscores the fact that long-term success with KLAL may require extension of SI beyond the first few years, albeit at lower levels individualized to each patient.en_US
dc.publisherLippincott, Williams & Wilkinsen_US
dc.subjectobservational studyen_US
dc.subjectopportunistic infectionen_US
dc.subjectorgan donoren_US
dc.titleLate Acute Rejection After Allograft Limbal Stem Cell Transplantation: Evidence for Long-Term Donor Survival.en_US
dc.typeArticleen_US


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