Corneal transplantation and immunosuppressants
Pakize Nur Akkaya1, Oytun Erbaş2
1Department of Histology and Embryology, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
2Department of Physiology, Demiroğlu Bilim University Faculty of Medicine, Istanbul, Turkey
Keywords: Cornea transplant, graft rejection, immune privilege, immunomodulators, immunosuppressants
Corneal graft is the most common and most transplanted tissue due to its immune privilege. After corneal transplantation, topical or systemic immunosuppression is applied depending on the patient’s case and condition. Immunosuppressants are a group of drugs that suppress the body's immune system and prevent organ rejection by preventing the transplanted organs from being perceived as foreign by the body and stimulating the body's natural immunity. Immunosuppressants are subdivided into corticosteroids, calcineurin inhibitors, interleukin 2 receptor blockers, and mTOR inhibitors. Inflammation or corneal vascularization in the transplant recipient increases the risk of graft rejection and affects the success of transplantation. To prevent rejection, systemic immunosuppressants are used in high-risk transplantation patients, however, long-term immunosuppressants have low efficacy and severe side effects, making it difficult to manage this process. Patient-specific immunomodulation therapy is currently thought to be the most effective treatment for the high-risk transplantation group. In this review, the characteristics, effects, and efficacy of topical and systemic immunosuppressants used in the post-transplantation period are described in scope of the possibility of corneal graft rejection after transplantation and according to the immune privilege of cornea and risk factors for corneal transplantation. Novel immunoregulators and cellular therapies that may increase the success of corneal transplantation without side effects of immunosuppressants are also emphasized.
Cite this article as: Akkaya PN, Erbaş O. Corneal transplantation and immunosuppressants. D J Tx Sci 2019;4(1-2):1-10.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.