BENEFICIAL EFFECT OF MATCHING AT THE HLA-A and-B AMINO-ACID TRIPLET LEVEL ON REJECTION-FREE CLEAR GRAFT SURVIVAL IN PENETRATING KERATOPLASY1

Objective. The beneficial effect of human leukocyte antigen (HLA) matching on long-term prognosis in penetrating keratoplasty is now unequivocal but has to be weighed against the additional waiting period on an individual basis. HLAMatchmaker is a molecularly based algorithm for histocompatibility determination that can identify immunologically acceptable mis-matches and thus potentially reduce time on the wait-ing list dramatically without negatively affecting prognosis. Methods. The HLAMatchmaker algorithm (triplet-string matching) was applied on each of 545 normal-risk keratoplasties for which complete HLA type was known at split-level resolution. Two homogenous groups were defined. Group I consisted of the 147 pen