title: Human leukocyte antigen-DR mismatched pediatric renal transplant: patient and graft outcome with different kidney donor sources.
abstract: OBJECTIVE
  Kidney transplant is well accepted as the optimal therapy for children with end-stage renal disease, and new trends suggest using human leukocyte antigen-DR mismatched grafts. The aim of work was to assess the effect of human leukocyte antigen-DR mismatch on the outcome of pediatric renal transplant recipients, regardless of the source of kidney graft.
  
  
  METHODS
  According to human leukocyte antigen-DR matching, 104 pediatric patients were categorized into 3 comparable groups. With optimized immunosuppression protocols, long-term graft and patient outcomes were assessed.
  
  
  RESULTS
  We found that posttransplant complications were comparable in the 3 groups, without significant increase in the risk of infections or malignancies, especially in the full human leukocyte antigen-DR-mismatched group. Moreover, we found no significant difference in the 3 groups regarding long-term graft or patient survival.
  
  
  CONCLUSIONS
  With optimization of immunosuppression, human leukocyte antigen-DR-mismatched donors can be safely accepted for pediatric kidney transplant with comparable long-term patient and graft survival.
authors.affiliation: From the Department of Nephrology, Hamed Al-Essa Organ Transplant Center, Kuwait.
authors.forename: Torki
authors.initials: T
authors.lastname: Al-Otaibi
authors.forename: Osama
authors.initials: O
authors.lastname: Gheith
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mosaad
authors.forename: M R Naryanan
authors.initials: MR
authors.lastname: Nampoory
authors.forename: Medhat
authors.initials: M
authors.lastname: Halim
authors.forename: Tarek
authors.initials: T
authors.lastname: Said
authors.forename: Prasad
authors.initials: P
authors.lastname: Nair
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control; D006085:Graft Survival / Q000187:drug effects; D006684:HLA-DR Antigens / Q000276:immunology*; D006648:Histocompatibility; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014019:Tissue Donors; D016896:Treatment Outcome
chemical_list: D006684:HLA-DR Antigens; D007166:Immunosuppressive Agents