Clinical and Pathologic Findings in Human Keratolimbal Allograft Rejection

Abstract

KLAL rejection is a newly recognized entity. Pathologic findings of rejected specimens indicate that this is a T-cell mediated rejection phenomenon. The pattern of cytokeratin staining provided little evidence that the epithelium covering KLALs had a corneal phenotype. The scarcity of vimentin-positive epithelial cells suggests that the stem-cell/transient-cell pool was probably depleted. Early recognition of clinical rejection is important, as treatment with immunosuppressive therapy may reverse the process.

Effect of Immunosuppression on Survival of Allograft Limbal Stem Cells

“…MHC Class II ϩ cells were observed mainly in the stroma and moderately in the epithelium. These findings are consistent with the study of Daya et al 14 in human eyes, which also showed large numbers of lymphocytes and MHC Class II ϩ cells in rejected limbal tissues, especially in the stroma. They suggested that cells in the stroma (macrophages) and epithelium (Langerhans cells and macrophages) were probably participating in antigen presentation.…”

Assessment of limbus and central cornea in patients with keratolimbal allograft transplantation using in vivo laser scanning confocal microscopy: an observational study

“…Investigation of the limbal graft in LSCD patients after KLAL using magnified photographic prints in the past was limited by the poor image quality due to low resolution. Some researchers have attempted to circumvent this limitation by examining the histopathology of patients' keratolimbal tissue obtained at the time of repeat surgery [19]. However, this only provides information of the transplants that have failed.…”

An Investigation of Removed Cultivated Epithelial Transplants in Patients After Allocultivated Corneal Epithelial Transplantation

“…14,15 Particularly characteristic is the process of lymphocyte infiltration. 16 We observed the presence of various inflammatory cells including lymphocytes, plasma cells, and macrophages as well as vascularization.…”