Despite similar treatment protocols, patient and graft survival rates of children are poorer than those observed in adults. This is in part related to an increased incidenceof, and an inability to reverserejection episodes. Inferior outcome might be due to lack of adequate immunosupression, increasedimmune reactivity which is resistant to therapy and/or a delay in clinical diagnosis of rejection with a resultant delay in the initiation of antirejection therapy. The overall objective of this multi-center study is to improve patient and graft survival by offering OKT3 induction therapy to pediatric recipients of renal allographs. We will conduct a randomized controlled clinical trial of 500 pediatric resipients. Secondly, we will perform kidney biopsies and peripheral blood assays in order to better understand how changing cellular, cytokine and molecular characteristics correlate with graft and graft rejection events.
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