Association of Donor and Recipient Smoking, Diabetes, and Age With Graft Failure and Rejection After Penetrating Keratoplasty.

IF 2.1 3区医学 Q2 OPHTHALMOLOGY

Cornea Pub Date : 2025-08-13 DOI:10.1097/ICO.0000000000003961

Hasan Alsetri, Ahmed Saeed Saad, Eric J Shiuey, Christopher J Rapuano, Zeba A Syed

{"title":"Association of Donor and Recipient Smoking, Diabetes, and Age With Graft Failure and Rejection After Penetrating Keratoplasty.","authors":"Hasan Alsetri, Ahmed Saeed Saad, Eric J Shiuey, Christopher J Rapuano, Zeba A Syed","doi":"10.1097/ICO.0000000000003961","DOIUrl":null,"url":null,"abstract":"Purpose: To evaluate whether the combined donor and recipient factors of smoking, diabetes, and age have an association with graft failure and rejection after penetrating keratoplasty (PK).Methods: Data from 597 eyes of 516 patients who underwent PK at a single tertiary center between May 2007 and September 2018 were included. Donor and recipient smoking, diabetes, and age were extracted from electronic medical records. The primary outcomes were graft failure and graft rejection. Cox proportional hazards models for graft failure and rejection were generated to assess significant risk factors.Results: The smoker donor-recipient pairing had a higher proportion of graft failures (57.6% vs. 31.5%), a higher hazard ratio (HR) for failure (1.69, 95% confidence interval [CI], 1.00-2.84), and a lower graft survival (2.85 years, 95% CI, 1.87-3.83 years vs. 4.81 years, 95% CI, 4.40-5.21 years) compared with the nonsmoker donor-recipient pairing (P < 0.05 for all). In addition, the low age donor-recipient pairing had a higher proportion of graft rejection (43.5% vs. 28.7%), a higher HR for rejection (2.11, 95% CI, 1.45-3.06), and a lower graft rejection-free survival (3.72 years, 95% CI, 3.20-4.20 years vs. 5.55 years, 95% CI, 4.97-6.13 years) compared with the high age donor-recipient pairing (P < 0.05 for all). Donor-recipient smoking was not associated with graft rejection, donor-recipient age was not associated with graft failure, and diabetic donor-recipient pairs did not yield significant associations with graft failure or rejection.Conclusions: Donor and recipient smoking and age could be jointly considered when counseling patients on graft outcomes.","PeriodicalId":10710,"journal":{"name":"Cornea","volume":" ","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cornea","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ICO.0000000000003961","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: To evaluate whether the combined donor and recipient factors of smoking, diabetes, and age have an association with graft failure and rejection after penetrating keratoplasty (PK).

Methods: Data from 597 eyes of 516 patients who underwent PK at a single tertiary center between May 2007 and September 2018 were included. Donor and recipient smoking, diabetes, and age were extracted from electronic medical records. The primary outcomes were graft failure and graft rejection. Cox proportional hazards models for graft failure and rejection were generated to assess significant risk factors.

Results: The smoker donor-recipient pairing had a higher proportion of graft failures (57.6% vs. 31.5%), a higher hazard ratio (HR) for failure (1.69, 95% confidence interval [CI], 1.00-2.84), and a lower graft survival (2.85 years, 95% CI, 1.87-3.83 years vs. 4.81 years, 95% CI, 4.40-5.21 years) compared with the nonsmoker donor-recipient pairing (P < 0.05 for all). In addition, the low age donor-recipient pairing had a higher proportion of graft rejection (43.5% vs. 28.7%), a higher HR for rejection (2.11, 95% CI, 1.45-3.06), and a lower graft rejection-free survival (3.72 years, 95% CI, 3.20-4.20 years vs. 5.55 years, 95% CI, 4.97-6.13 years) compared with the high age donor-recipient pairing (P < 0.05 for all). Donor-recipient smoking was not associated with graft rejection, donor-recipient age was not associated with graft failure, and diabetic donor-recipient pairs did not yield significant associations with graft failure or rejection.

Conclusions: Donor and recipient smoking and age could be jointly considered when counseling patients on graft outcomes.

查看原文本刊更多论文

供体和受体吸烟、糖尿病和年龄与穿透性角膜移植术后移植失败和排斥反应的关系。

目的：评价吸烟、糖尿病和年龄等供体和受体因素是否与穿透性角膜移植术（PK）后移植失败和排斥反应有关。方法：纳入2007年5月至2018年9月在单一三级中心接受PK的516例患者的597只眼睛的数据。从电子病历中提取供体和受体吸烟、糖尿病和年龄。主要结果是移植物衰竭和移植物排斥反应。建立移植失败和排斥反应的Cox比例风险模型来评估重要的危险因素。结果：与非吸烟者供体-受体配对组相比，吸烟者供体-受体配对组移植失败的比例更高（57.6%比31.5%），失败的风险比（HR）更高（1.69,95%可信区间[CI]， 1.00-2.84），移植生存期更低（2.85年，95% CI, 1.87-3.83年比4.81年，95% CI, 4.40-5.21年）（均P < 0.05）。此外，与高年龄供体-受体配对相比，低年龄供体-受体配对有更高的移植排斥比例（43.5%比28.7%），更高的排斥风险比（2.11,95% CI, 1.45-3.06），以及更低的移植无排斥生存（3.72年，95% CI, 3.20-4.20年比5.55年，95% CI, 4.97-6.13年）（P < 0.05）。供体-受体吸烟与移植排斥反应无关，供体-受体年龄与移植失败无关，糖尿病供体-受体对与移植失败或排斥反应没有显著关联。结论：在对患者进行移植物预后咨询时，可联合考虑供体和受体吸烟和年龄。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cornea 医学-眼科学

CiteScore

5.20

自引率

10.70%

发文量

354

审稿时长

3-6 weeks

期刊介绍： For corneal specialists and for all general ophthalmologists with an interest in this exciting subspecialty, Cornea brings together the latest clinical and basic research on the cornea and the anterior segment of the eye. Each volume is peer-reviewed by Cornea''s board of world-renowned experts and fully indexed in archival format. Your subscription brings you the latest developments in your field and a growing library of valuable professional references. Sponsored by The Cornea Society which was founded as the Castroviejo Cornea Society in 1975.