ESCRS - FP106 - CARRYING OUT A THERAPEUTIC PLASMAPHERESIS COURSE TO PREVENT GRAFT DISEASE IN KERATOPLASTY PATIENTS: IMMUNOLOGICAL AND CLINICAL RESULTS

CARRYING OUT A THERAPEUTIC PLASMAPHERESIS COURSE TO PREVENT GRAFT DISEASE IN KERATOPLASTY PATIENTS: IMMUNOLOGICAL AND CLINICAL RESULTS

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP106 | Type: Abstracts | DOI: 10.82333/spak-rj97

Authors: Sergey Sakhnov 1 , Victoria Myasnikova 2 , Sergey Kravchenko 2 , Tamriko Zakaraiia* 2

1Department of Administration,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation, 2Department of Science,S Fyodorov Eye Microsurgery Federal State Institution,Krasnodar,Russian Federation

Purpose

Plasmapheresis is an effective method in transplantology to prevent graft rejection (kidney, heart, liver) by removing components associated with immunological processes from the blood plasma.  However, the issue of the application of this method in corneal transplantation has not been practically studied and there are only theoretical ideas about its potential effectiveness. The aim of our study is to evaluate the immunological and clinical effectiveness of plasmapheresis as a method to prevent and treat graft rejection reactions in keratoplasty. 

Setting

Prospective study conducted at the S Fyodorov Eye Microsurgery Federal State Institution - Krasnodar, Russia. 

Methods

The study involved patients, who underwent a course of plasmapheresis and penetrating keratoplasty (main group, analyzed prospectively) and patients who underwent penetrating keratoplasty, but did not undergo plasmapheresis (comparison group, analyzed retrospectively). The control group consisted of conditionally healthy individuals of both genders. Subgroups of patients with high and low risk keratoplasty were also identified within the Main group and the Comparison group. Investigated were: the level of C-reactive protein (CRP), stimulated cytochemical index (SCI), the mobilization coefficient (MC) and the levels of the interleukins (IL1β, IL6, IL17) after the course of plasmapheresis and keratoplasty.  

Results

Patients who received a course of plasmapheresis demonstrated a statistically significant decrease in the level of CRP and mean SCI and the MC. The patients showed different dynamics of the levels of the studied IL after the course of plasmapheresis depending on the risk group for keratoplasty. In patients of the Comparison group the maximum number of cases of graft disease (n = 24) was observed in the first 500 days after surgery. The patients of the Main group who underwent plasmapheresis had the best graft survival rates: during the observation period, there were no cases of graft disease. 

Conclusion

In patients of the Comparison group who did not receive a course of plasmapheresis in the preoperative period, over a period of 1.3 years, 22 cases (24%) developed graft disease, while patients of both subgroups of the Main group who received a course of therapeutic plasmapheresis in the preoperative period, didn’t demonstrate any cases of graft disease. The obtained data indicate the ability of plasmapheresis, performed in the perioperative period, to prevent the development of graft disease in patients with keratoplasty.