Through a glass darkly: Seeking clarity in preventing late kidney transplant failure

Mark D Stegall, Robert S. Gaston, Fernando G Cosio, Arthur Matas

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

A common lament is that long-term kidney transplant outcomes remain the same despite improvements in early graft survival. To be fair, progress has been made - in both our understanding of chronic injury and modestly, graft survival. However, we are still a long way from actually solving this important and difficult problem. In this review, we outline recent data supporting the existence of several causes of renal allograft loss, the incidences of which peak at different time points after transplantation. On the basis of this broadened concept of chronic renal allograft injury, we examine the challenges of clinical trial design in longterm studies, including the use of surrogate end points and biomarkers. Finally, we suggest a path forward that, ultimately, may improve long-term renal allograft survival.

Original languageEnglish (US)
Pages (from-to)20-29
Number of pages10
JournalJournal of the American Society of Nephrology
Volume26
Issue number1
DOIs
StatePublished - Jan 1 2015

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ASJC Scopus subject areas

  • Nephrology

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