Evidence map›Paper›PMID 31765363›Full record

ReviewTransplantation2019

High-risk Corneal Transplantation: Recent Developments and Future Possibilities.

W John Armitage, Christine Goodchild, Matthew D Griffin, David J Gunn, Jesper Hjortdal, Paul Lohan, Conor C Murphy, Uwe Pleyer, Thomas Ritter, Derek M Tole and 1 more

Registry-linked trialAbstract readReview
In one paragraph

Review in Transplantation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06281587 (Pathogenetic Risk Factors for Corneal Graft Rejection in Penetrating Keratoplasty Patients), which is not on this map. Cited by 70 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
70citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06281587 completednot on this map

Pathogenetic Risk Factors for Corneal Graft Rejection in Penetrating Keratoplasty Patients

TypeobservationalSponsorThe S.N. Fyodorov Eye Microsurgery State InstitutionRan2011 to 2019Enrolled93ConditionsGraft RejectionArmspenetrating keratoplasty
3 · Its place in the literature

Who cites it

70 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Prescription patterns in DMEK: European survey.Journal of cataract and refractive surgery · 2025
    Article
  11. Review
  12. Review
  13. Review
  14. Article
  15. Review
  16. Article
  17. Review
  18. Changing indications for keratoplasty: monocentric analysis of the past two decades.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2025
    Article
  19. Article
  20. Evolution of the ocular immune system.Eye (London, England) · 2025
    Review

10 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

W John ArmitageBristol Medical School, University of Bristol, Bristol Eye Hospital and NHS Blood and Transplant, United Kingdom.
Christine GoodchildRoyal College of Surgeons in Ireland and Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Matthew D GriffinRegenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland.
David J GunnUniversity Hospitals Bristol NHS Foundations Trust, Bristol Eye Hospital, United Kingdom.
Jesper HjortdalDepartment of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.
Paul LohanRegenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland.
Conor C MurphyRoyal College of Surgeons in Ireland and Royal Victoria Eye and Ear Hospital, Dublin, Ireland.
Uwe PleyerDepartment of Ophthalmology, Charité University Hospital, Berlin, Germany.
Thomas RitterRegenerative Medicine Institute (REMEDI) at CÚRAM Centre for Research in Medical Devices, School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Ireland.
Derek M ToleUniversity Hospitals Bristol NHS Foundations Trust, Bristol Eye Hospital, United Kingdom.
Bertrand VabresDepartment of Ophthalmology, CHU de Nantes, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Human corneal transplantation (keratoplasty) is typically considered to have superior short- and long-term outcomes and lower requirement for immunosuppression compared to solid organ transplants because of the inherent immune privilege and tolerogenic mechanisms associated with the anterior segment of the eye. However, in a substantial proportion of corneal transplants, the rates of acute rejection and/or graft failure are comparable to or greater than those of the commonly transplanted solid organs. Critically, while registry data and observational studies have helped to identify factors that are associated with increased risk of corneal transplant failure, the extent to which these risk factors operate through enhancing immune-mediated rejection is less clear. In this overview, we summarize a range of important recent clinical and basic insights related to high-risk corneal transplantation, the factors associated with graft failure, and the immunological basis of corneal allograft rejection. We highlight critical research areas from which continued progress is likely to drive improvements in the long-term survival of high-risk corneal transplants. These include further development and clinical testing of predictive risk scores and assays; greater use of multicenter clinical trials to optimize immunosuppressive therapy in high-risk recipients and robust clinical translation of novel, mechanistically-targeted immunomodulatory and regenerative therapies that are emerging from basic science laboratories. We also emphasize the relative lack of knowledge regarding transplant outcomes for infection-related corneal diseases that are common in the developing world and the potential for greater cross-pollination and synergy between corneal and solid organ transplant research communities.

Indexed as

AllograftsCorneal DiseasesCorneal TransplantationGraft RejectionGraft SurvivalHumansImmunosuppressive AgentsRisk FactorsImmunosuppressive Agents

Identifiers

PMID31765363
PMCPMC6867666

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.