Why hasn't eliminating acute rejection improved graft survival?

JogiRaju Tantravahi, Karl L. Womer, Bruce Kaplan

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Although patients with end-stage renal disease can be maintained with dialysis therapy, the superiority of patient survival with renal transplantation makes transplantation the preferred method of renal replacement. Potent immunosuppressive therapies, particularly calcineurin inhibitors, have greatly reduced the incidence of acute rejection. However, long-term allograft survival remains limited. We discuss the impact of acute rejection on long-term allograft survival and discuss other factors leading to late allograft loss, including calcineurin inhibitor toxicity, chronic allograft nephropathy, and BK virus nephropathy, as well as donor and recipient factors associated with long-term allograft loss.

Original languageEnglish (US)
Pages (from-to)369-385
Number of pages17
JournalAnnual Review of Medicine
StatePublished - 2007
Externally publishedYes


  • Allograft survival
  • BK virus nephropathy
  • Calcineurin inhibitor toxicity
  • Chronic allograft nephropathy
  • Donor and recipient factors
  • Kidney transplantation

ASJC Scopus subject areas

  • Cell Biology
  • General Medicine


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