Does human lymphocyte antigen matching improve the outcome in pediatric renal transplants?
Adult studies have shown a high renal graft survival if the donor and recipient match for each antigen of the human lymphocyte antigen (HLA)-A, B and DR loci (six-antigen match). The 4 yr of data from the North American Pediatric Renal Transplant Cooperative Study Registry show a statistically beneficial effect of DR matching for cadaver graft outcome. No antigen matching clearly has a worse outcome, 72% at 1 yr versus those with one or more antigen matching at each loci with a 1-yr graft survival of 81% and 2-yr graft survival of 69%. The long-term improved outcome from better antigen matching suggests that cadaver donor allograft organ assignment should address both the need of the center-driven and patient-driven concepts of recipient selection to achieve the best use of this scarce resource and an improved quality of life.
McEnery
P T
PT
Division of Pediatric Nephrology, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
Stablein
D M
DM
D002102:Cadaver; D002648:Child; D006085:Graft Survival; D006680:HLA Antigens / Q000032:analysis*; D006648:Histocompatibility; D006801:Humans; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation / Q000276:immunology*; D016016:Proportional Hazards Models; D012042:Registries; D012306:Risk; D014019:Tissue Donors
D006680:HLA Antigens