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COMMENTS AND OPINIONS
The Effect of HLA-DR Matching on Pediatric Kidney Transplantation
Vincenzo Grimaldi, BiolD, MS;
Claudio Napoli, MD, PhD
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The interesting study by Vu et al1 describes the impact of HLA-DR mismatching on rejection, graft survival, and sensitization in pediatric kidney transplantation. They considered that HLA-DRB1 mismatches were a significant risk factor for rejection but not for graft failure or sensitization. However, history of rejection was an independent predictor of graft failure and sensitization. Their study was performed for a population of pediatric patients with a pretransplantation panel reactive antibody level of 0% to show the effect of HLA-DR mismatches on sensitization. Based on a previous observation,2 it would be interesting to study an immunized population with pretransplantation panel reactive antibody levels of greater than 0% in order to evaluate the effect of HLA-DR mismatches on the posttransplantation levels of panel reactive antibody, on rejection, and on graft survival. Moreover, the HLA-DR mismatch may influence long-term graft survival,3 so it would . . . [Full Text of this Article]
AUTHOR INFORMATION
Author Affiliations: Unità Operativa Complessa Division of Immunohematology, Transfusion Medicine, and Transplantion Immunology, Regional Reference Laboratory of Transplantion Immunology, Azienda Ospedaliera Universitaria, Second University of Naples, Italy.
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RELATED LETTER
The Effect of HLA-DR Matching on Pediatric Kidney Transplantation—Reply
Peter G. Stock
Arch Surg. 2012;147(1):97-98.
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