Late Allograft Loss of Function: Recurrence of Disease, Chronic Allograft Injury (Immune and Nonimmune Mediated), and Retransplantation

Reference work entry
Part of the Organ and Tissue Transplantation book series (OTT)

Abstract

Renal transplantation is accepted as the treatment of choice for children with end-stage renal disease (ESRD). Over the past decade, improved short-term graft survival has been observed in children and adults with kidney transplantation; however, long-term survival has not improved. The causes of renal allograft dysfunction vary with the time after transplantation. Slowly progressive renal disease that occurs over a period of years after renal transplantation most commonly results from chronic allograft injury, calcineurin inhibitor toxicity, hypertensive nephrosclerosis, viral infections, and recurrent or de novo renal disease. Preventable causes of late allograft failure are important to identify in order to improve the long-term successful outcome of allograft survival. Retransplantation in the pediatric population is likely to be common into adulthood. Primary reasons for late allograft failure will impact the success of retransplantation.

Keywords

Chronic allograft nephropathy Chronic kidney disease Antibody-mediated rejection Focal segmental glomerulosclerosis recurrence Proteinuria Calcineurin inhibitor toxicity Donor-specific antibodies Allograft nephrectomy BK nephropathy Retransplantation 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of NephrologyThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA

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