title: HLA matching in pediatric recipients of a first kidney graft. A single center analysis.
abstract: We retrospectively examined the effect of HLA-A, -B, and -DR serological matching on graft survival in 88 pediatric end-stage renal disease patients who underwent primary renal transplantation. Actuarial graft survivals (GS) at 2 and 6 years in patients with zero DR mismatches (MM) (12 patients) or 1 DR MM (58 patients) were significantly higher than those in patients with 2 DR MM (18 patients) (2-year GS: 100% vs. 90% vs. 59%; 6-year GS: 100% vs. 79% vs. 59%, respectively). Because of the low number of patients in the zero DR MM group, only the GS difference between 1 DR MM and 2 DR MM had a significant result at 1 year (92% vs. 68%). No clear HLA matching effect was obtained in the HLA-A and -B loci. When DR were combined with A or B antigens (0-2 MM vs. 3-4 MM), significantly higher GS at 1, 2, and 6 years persisted for patients with 0-2 MM only in the A, DR group (96%, 94%, and 85% vs. 68%, 63%, and 56%, respectively). It is suggested that avoidance of mismatching for DR alleles at the serological level, in the selection of pediatric recipients of first cadaveric renal transplantation, leads to an improvement of both short- and longterm graft outcome.
authors.affiliation: Department of Immunology, S. Martino Hospital, Genoa, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Barocci
authors.forename: U
authors.initials: U
authors.lastname: Valente
authors.forename: R
authors.initials: R
authors.lastname: Gusmano
authors.forename: F
authors.initials: F
authors.lastname: Torre
authors.forename: G
authors.initials: G
authors.lastname: Basile
authors.forename: I
authors.initials: I
authors.lastname: Fontana
authors.forename: V
authors.initials: V
authors.lastname: Arcuri
authors.forename: F
authors.initials: F
authors.lastname: Olmi
authors.forename: G
authors.initials: G
authors.lastname: Angelini
authors.forename: A
authors.initials: A
authors.lastname: Nocera
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006085:Graft Survival / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology*; D006650:Histocompatibility Testing; D006801:Humans; D016030:Kidney Transplantation / Q000276:immunology*
chemical_list: D006680:HLA Antigens