title: Does human lymphocyte antigen matching improve the outcome in pediatric renal transplants?
abstract: 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.
authors.affiliation: Division of Pediatric Nephrology, Children's Hospital Medical Center, Cincinnati, OH 45229-2899.
authors.forename: P T
authors.initials: PT
authors.lastname: McEnery
authors.forename: D M
authors.initials: DM
authors.lastname: Stablein
mesh_terms: 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
chemical_list: D006680:HLA Antigens