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 incidence of, and an inability to reverse, rejection episodes. Inferior outcome might be due to lack of adequate immunosuppression, increased immune reactivity which is resistant to therapy and/ or and a delay in the clinical diagnoses of rejection with a resultant delay in the initiation of antirejection therapy. The overall objective of this multi-center study is to improve patient & graft survival by offering OKT3 induction therapy to pediatric recipients of renal allographs. We will conduct a randomized controlled clinical trial of 500 pediatric recipients. 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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