A patient is being evaluated for a kidney transplant. Of the following individuals, who is the most likely candidate to provide a kidney to the patient?
1. live kidney transplant from an older brother
2. live kidney transplant from a donor bank
3. cadaver kidney transplant
4. live kidney transplant from an identical twin
4
Rationale: Identical twins have the same histocompatibility pairings and are perfect human leukocyte antigen matches. In the case of identical twins, a transplanted tissue or organ is recognized as having a self- human leukocyte antigen fingerprint and is accepted into the recipient without an immune assault. Because full siblings share the same biological parents, they often have some degree of human leukocyte antigen matching. The closer the human leukocyte antigen combination matches between two people, the more the "fingerprint" is recognized as self. Since a multitude of combinations of pairings can occur, complete human leukocyte antigen matching is virtually impossible with the exception of identical twins. In contrast, transplanted cadaver organs are completely unmatched when chosen randomly for an organ recipient.
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