{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:45:13Z","timestamp":1790689513487,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,10,6]],"date-time":"2021-10-06T00:00:00Z","timestamp":1633478400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Approximately 1700 children per year with end\u2010stage kidney disease undergo kidney transplantation in Europe and the United States of America; 30%\u201350% are living donor kidney transplantations. There may be immunological differences between paternal and maternal donors due to transplacental exchange of cells between the mother and fetus during pregnancy leading to microchimerism. We investigated whether the outcome of living\u2010related kidney transplantation in young children is different after maternal compared with paternal organ donation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the international Collaborative Transplant Study (CTS) database, we analyzed epidemiological data of 7247 children and adolescents aged &lt;18\u00a0years who had received a kidney transplant from either mother or father. Risk of treated rejection episodes and death\u2010censored graft failure were computed using the Kaplan\u2010Meier method and multivariable Cox regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the recipient age group 1\u20134\u00a0years, the rate of treated rejection episodes in recipients of kidneys from maternal donors (<jats:italic>N<\/jats:italic>\u00a0=\u00a0195) during the first 2\u00a0years post\u2010transplant was significantly lower (hazard ratio HR\u00a0=\u00a00.47, <jats:italic>p\u00a0<\/jats:italic>=\u00a0.004) than in patients receiving kidneys from paternal donors (<jats:italic>N<\/jats:italic>\u00a0=\u00a0179). This association between donor sex and risk of treated rejections was not observed in children aged 5\u20139\u00a0years. The 5\u2010year death\u2010censored graft survival in children aged 1\u20134\u00a0years with a maternal or paternal donor was comparable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Maternal kidney donation in young pediatric renal transplant recipients is associated with an approximately 50% lower rate of treated rejection than paternal kidney donation. Whether this phenomenon is due to maternal microchimerism\u2010induced donor\u2010specific hyporesponsiveness must be evaluated in prospective mechanistic studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.14154","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T16:39:35Z","timestamp":1633711175000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Maternal versus paternal living kidney transplant donation is associated with lower rejection in young pediatric recipients: A Collaborative Transplant Study report"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0873-3631","authenticated-orcid":false,"given":"Geraldine","family":"Engels","sequence":"first","affiliation":[{"name":"Department of Pediatrics University Children\u2019s Hospital University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"},{"name":"Department of Pediatrics University of W\u00fcrzburg W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernd","family":"D\u00f6hler","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Transplantation Immunology Heidelberg University Hospital Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burkhard","family":"T\u00f6nshoff","sequence":"additional","affiliation":[{"name":"Department of Pediatrics I University Children\u2019s Hospital, University of Heidelberg Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University Children\u2019s Hospital University Medical Center Hamburg\u2010Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kruchen","sequence":"additional","affiliation":[{"name":"Division of Pediatric Stem Cell Transplantation and Immunology, Department of Pediatric Hematology and Oncology University Medical Center Hamburg\u2010 Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Division of Pediatric Stem Cell Transplantation and Immunology, Department of Pediatric Hematology and Oncology University Medical Center Hamburg\u2010 Eppendorf Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caner","family":"S\u00fcsal","sequence":"additional","affiliation":[{"name":"Institute of Immunology, Transplantation Immunology Heidelberg University Hospital Heidelberg 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