Eyeing up the ladies' corneas

Gender-matched corneal donations could help to reduce cornea donation rejection rates, according to a new study from the University of Liverpool.

The research, published in the American Journal of Transplantation, found that male corneas donated to female patients had a higher risk of failing or being rejected than gender-matched corneal donations, or female corneas donated to male patients.

The effects of gender matching were most pronounced in patients with Fuchs endothelial dystrophy, paper author and University of Liverpool researcher, Professor Stephen Kaye, said.

With fellow lead author, Cathy Hopkinson, of NHS Blood and Transplant, Professor Kaye concluded that the H-Y antigen that sat on the surface of corneal cells was the likely cause of the increased rejection rates. 

This antigen, which can trigger the body’s immune response, was thought to be responsible for increased rejection rates in other types of organ donation, including kidney transplants. The DNA instructions for the H-Y antigen are on the Y chromosome.

Professor Kaye told OT that there was some evidence that this immune response was happening in corneal donations before the team began the study.

He explained: “Females do not have a Y chromosome so there is no H-Y incompatibility from female donors to male patients.”

Further studies are required to confirm the paper’s findings, Professor Kaye emphasised, adding: “If confirmed, this would be relatively straightforward to put into place, without delay in donor tissue allocation to patients or any significant added cost.

“The long-term impact this could have on patient care may be substantial,” he concluded.

Meanwhile, a new procedure – which removes a few square millimetres of a single layer of corneal cells, prompting regeneration – may mean corneal donations for patients with Fuchs endothelial dystrophy become unnecessary.

A new study, published in the journal Cornea, of 11 patients who underwent the new procedure at Harvard Medical School leant weight to the potential of this technique.

Image credit: Megor1