Does HLA matching matter in the modern era of renal transplantation?
Deceased donors
Human leukocyte antigens
Kidney transplantation
Living donors
Matching
Mismatching
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
01 2021
01 2021
Historique:
received:
19
02
2019
accepted:
06
09
2019
revised:
02
07
2019
pubmed:
11
12
2019
medline:
15
12
2021
entrez:
11
12
2019
Statut:
ppublish
Résumé
Children with end-stage kidney disease should be offered the best chance for future survival which ideally would be a well-matched pre-emptive kidney transplant. Paediatric and adult practice varies around the world depending on geography, transplant allocation schemes and different emphases on living (versus deceased) donor renal transplantation. Internationally, paediatric patients often have priority in allocation schemes and younger donors are preferentially allocated to paediatric recipients. HLA matching can be difficult and may result in longer waiting times. Additionally, with improved surgical techniques and modern immunosuppressive regimens, how important is the contribution of HLA matching to graft longevity? In this review, we discuss the relative importance of HLA matching compared with donor quality; and long-term patient outcomes including re-transplantation rates. We share empirical evidence that will be useful for clinicians and families to make decisions about best donor options. We discuss why living donation still provides the best allograft survival outcomes and what to do in the scenario of a highly mismatched living donor.
Identifiants
pubmed: 31820146
doi: 10.1007/s00467-019-04393-6
pii: 10.1007/s00467-019-04393-6
pmc: PMC7701071
doi:
Substances chimiques
HLA Antigens
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
31-40Subventions
Organisme : Department of Health
Pays : United Kingdom
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