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Abstract

Objectives: 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. Materials and 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.