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Amniotic membrane transplantation—a new approach to crossing the HLA barriers in the treatment of refractory ocular graft-versus-host disease

Ocular chronic graft-versus-host disease (oGVHD) occurs in 40-60% of patients after allogeneic hematopoietic stem cell transplantation (allo- HSCT) [1]. Severe forms of oGVHD can be devastating since they restrict daily activities and severely deteriorate quality of life. Amniotic membrane (AM) is an avascular fetal membrane collected from placental tissue during elective cesarean sections, from donors screened for transmissible infectious diseases. As it lacks HLA-A, HLA-B and HLA-DR antigens, AM is universally tolerated and can be used without fear of rejection. In our institution, AMT is used for the treatment of severe oGVHD refractory to all available local and systemic therapy. Herein we report clinical course and outcomes of first four consecutive patients who underwent the AMT procedure as salvage therapy for oGVHD.

amniotic membrane ; ocular GVHD ; bone marrow transplantation

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