PMID- 23759881
OWN - NLM
STAT- MEDLINE
DCOM- 20131104
LR  - 20220318
IS  - 1534-6080 (Electronic)
IS  - 0041-1337 (Linking)
VI  - 96
IP  - 5
DP  - 2013 Sep 15
TI  - Relative importance of HLA mismatch and donor age to graft survival in young 
      kidney transplant recipients.
PG  - 469-75
LID - 10.1097/TP.0b013e318298f9db [doi]
AB  - BACKGROUND: The American deceased-donor (DD) kidney allocation algorithm for 
      children emphasizes the importance of younger donors and shorter waiting times 
      over human leukocyte antigen (HLA) matching. We sought to compare the relative 
      importance of donor age with that of HLA mismatching (MM) on graft survival. 
      METHODS: We studied patients less than 21 years old recorded in the U.S. Renal 
      Data System, who received a first transplant from a DD 5 years old or younger or 
      from a living donor (LD). Using separate Cox proportional hazards models for DD 
      and LD recipients, we estimated the adjusted 5-year probability of graft survival 
      for each donor age-HLA MM combination and compared estimated graft survival 
      across the different HLA MM-donor age combinations. RESULTS: Both donor age and 
      HLA MM were significantly associated with DD graft survival, whereas only HLA MM 
      had a significant association with LD graft survival. Compared with DD grafts 
      from less than 35-year-old 4-6 MM donors, survival was not significantly 
      different for 0-1 and 2-3 MM grafts from 35- to 44-year-old donors or for 0-1 MM 
      grafts from donors 45 years old or older. The most poorly matched grafts from the 
      oldest LD had survival similar to or better than any DD. CONCLUSIONS: Donor age 
      and HLA MM both play important roles in determining DD graft survival. The 
      advantages of younger donors offset the disadvantages of poorer HLA matching, and 
      better HLA matching offsets the disadvantages of older donor age.
FAU - Foster, Bethany J
AU  - Foster BJ
AD  - Division of Nephrology, Department of Pediatrics, McGill University Faculty of 
      Medicine, Montreal, Quebec, Canada.beth.foster@muhc.mcgill.ca
FAU - Dahhou, Mourad
AU  - Dahhou M
FAU - Zhang, Xun
AU  - Zhang X
FAU - Platt, Robert W
AU  - Platt RW
FAU - Hanley, James A
AU  - Hanley JA
LA  - eng
GR  - MOP-84337/Canadian Institutes of Health Research/Canada
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Transplantation
JT  - Transplantation
JID - 0132144
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - *Graft Survival
MH  - *Histocompatibility Testing
MH  - Humans
MH  - *Kidney Transplantation
MH  - Living Donors
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - *Tissue Donors
EDAT- 2013/06/14 06:00
MHDA- 2013/11/05 06:00
CRDT- 2013/06/14 06:00
PHST- 2013/06/14 06:00 [entrez]
PHST- 2013/06/14 06:00 [pubmed]
PHST- 2013/11/05 06:00 [medline]
AID - 10.1097/TP.0b013e318298f9db [doi]
PST - ppublish
SO  - Transplantation. 2013 Sep 15;96(5):469-75. doi: 10.1097/TP.0b013e318298f9db.