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Whole eye transplantation: allograft survival with Tacrolimus immunosuppression and comparison to syngeneic transplantation.
Wendy Chen, Jila Noori, Lin He, Chiaki Komatsu, Maxine R Miller, Ian A Rosner, Wenshang Zhang, Kira L Lathrop, Joshua M Barnett, Yong Wong, Bing Li, Mario G Solari, Charleen T Chu, Kia M Washington
University of Pittsburgh
2018-01-31
Presenter: Wendy Chen, MD, MS
Affidavit:
This project was the primary project of this resident during her time in the laboratory.
Director Name: Vu T Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background: Blindness is a devastating condition affecting millions of patients. Whole eye transplantation (WET) is a potential solution. Our lab has established a viable rodent model with promising results in syngeneic transplants. To investigate allotransplantation, successful immunosuppression is necessary. Tacrolimus monotherapy is successful in rodent VCA and has possible neuroprotective effects in the central nervous system and injured optic nerve, but its efficacy in WET is unknown.
Methods: Brown-Norway to Lewis rat transplants were performed (n=6), followed by daily intraperitoneal 1mg/kg Tacrolimus injection. Animals were examined at weeks 1, 3, 5, and 6 and compared to syngeneic transplants. Exams included Optical Coherence Tomography (OCT), clinical examination by retinal specialist, intraocular pressures, and histology interpreted by ocular pathologist.
Results: Compared to syngeneic transplants, allografts demonstrated comparable corneal thickening, retinal thinning, and blood flow in the central retinal artery and vein (OCT). Intraocular pressures were normal and comparable to syngeneic transplants. On clinical examination, both groups had mild corneal anomalies, but allografts had more frequent fundus and optic nerve ischemia (moderate). Histologically, both groups had global ocular chronic inflammation, some degree of retinal degeneration, but, in contrast to allografts, syngeneic transplants actually showed consistent degeneration of the optic nerve.
Conclusion: This is the first study of orthotopic allograft eye transplantation and immunosuppression. Compared to syngeneic transplants, allografts had increased ischemia, but less optic nerve degeneration, without signs of rejection. Overall preservation of ocular structures is an exciting first step. With this, we can begin to explore innumerable new questions in eye transplantation.
