Donor and Recipient Sex Matching and Corneal Graft Failure in High-Risk and Non-High-Risk Patients

Purpose. It is controversial whether donor-recipient sex mismatch is a risk factor associated with corneal graft failure. The purpose of this study was to investigate the effect of sex mismatch on corneal graft failure in high-risk and non-high-risk patients. Design. A retrospective study. Methods. The medical charts of patients who underwent corneal transplantations by one surgeon between 2012 and 2017 were reviewed. Patients were defined as high-risk for failure if they had glaucoma, ocular surface disease, or corneal vascularization. Graft failure rates were compared using the Kaplan-Meier survival curves between sex matched and mismatched subjects and between male-to-female grafting and other patients. Results. One hundred and thirteen patients with a minimum follow-up of 18 months were included. In 62 non-high-risk patients, graft failure rates were similar between the sex mismatched and the sex matched recipients (p=0.645, log-rank) and in male donor to female recipient transplantations and in the other transplantations (p=0.496, log-rank). Analysis of fifty-one eyes of 51 high-risk graft recipients (mean age of 73.4 +/- 12.7 years, N = 26 females) showed that graft failure rates were significantly higher in the sex mismatched than sex matched recipients (p=0.022, log-rank) and in male donor to female recipient transplantations than in the other transplantations (p=0.002, log-rank). Conclusions. Sex matching for every patient bares logistic difficulties; however, in patients who are at high-risk for graft failure, it may be a simple way to improve outcomes and better utilize corneal grafts.Peer reviewe

Baseline clinical characteristics of the study population by cardiorespiratory fitness group.

Baseline clinical characteristics of the study population by cardiorespiratory fitness group.</p

Participants selection flow chart.

A participant flow chart describing the selection process for our study population. CVD = cardiovascular disease; IHD = ischemic heart disease; CVA = cerebrovascular accident; AF = atrial fibrillation.</p

Unadjusted OR of elevated IOP by fitness group.

The difference in OR between the first quintile and the rest of the quintiles can be seen clearly. This finding has led to the separation and definition of quintile 1 as the low CRF group and quintiles 2–5 as non-low CRF group. OR = odds ratio; IOP = intra ocular pressure; CRF = cardiorespiratory fitness.</p

Human participants research checklist.

PurposeTo evaluate the association of cardiorespiratory fitness with elevated intraocular pressure (IOP) in healthy adults.MethodsIn this cross-sectional study, we evaluated 17,990 asymptomatic self-referred adults free of diabetes or cardiovascular disease who were screened in a preventive healthcare setting. All subjects underwent measurement of IOP and completed a maximal exercise stress test according to the Bruce protocol. Fitness was categorized into age and sex-specific quintiles according to the treadmill time and dichotomized to low (lowest quintile) and non-low fitness groups. Elevated IOP was defined as ≥ 21 mmHg.ResultsMedian age was 45 (IQR 39–52) years and 12,073 (67%) were men. There were 3,351 (19%) subjects in the low fitness group. Median IOP was 14 mmHg (IQR 12–16) with elevated IOP documented in 188 (1%) subjects. Univariate binary logistic regression model demonstrated that compared with non-low fitness group, subjects in the low fitness group were 2.2 times more likely to have elevated IOP (95% CI 1.598–2.95, pConclusionsLow cardiorespiratory fitness is independently associated with increased IOP among apparently healthy adults.</div

Univariate and multivariate binary logistic regression models, using the same variables for the prediction of elevated IOP.

Univariate and multivariate binary logistic regression models, using the same variables for the prediction of elevated IOP.</p