Abstract
Corneal homograft rejection occurs spontaneously in 15% of feline penetrating keratoplasties. The incidence of rejection can be increased to 100% by exchanging full-thickness skin grafts between matched corneal donor pairs after successful corneal transplantation. Rejecting corneal grafts initially develop keratic precipitates with aqueous cell and flare. Subsequently, the cornea opacities due to endothelial decompensation with associated bullous keratopathy and stromal vascularization. Surviving endothelial cells undergo compensatory hypertrophy as the rejection progresses. Rejecting corneal grafts exhibit an extensive population of mononuclear cells adhering specifically to the graft endothelium with eventual loss of the endothelium. Cats with successful corneal homografts before induced rejection exhibit systemic cellular immune suppression based upon mixed lymphocyte cultures. During rejection, the same animals exhibit an enhanced systemic cellular immune reactivity with clonal expansion of cultured lymphocytes. Sequential hematologic examinations also emphasize the importance of the host cellular immune system in feline graft rejection.
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