Pediatric Nephrology

, Volume 34, Issue 2, pp 211–222 | Cite as

Non-immunologic allograft loss in pediatric kidney transplant recipients

  • Isa F. AshoorEmail author
  • Vikas R. Dharnidharka
Educational Review
Part of the following topical collections:
  1. What’s New in Renal Transplantation


Non-immunologic risk factors are a major obstacle to realizing long-term improvements in kidney allograft survival. A standardized approach to assess donor quality has recently been introduced with the new kidney allocation system in the USA. Delayed graft function and surgical complications are important risk factors for both short- and long-term graft loss. Disease recurrence in the allograft remains a major cause of graft loss in those who fail to respond to therapy. Complications of over immunosuppression including opportunistic infections and malignancy continue to limit graft survival. Alternative immunosuppression strategies are under investigation to limit calcineurin inhibitor toxicity. Finally, recent studies have confirmed long-standing observations of the significant negative impact of a high-risk age window in late adolescence and young adulthood on long-term allograft survival.


Allograft dysfunction Calcineurin inhibitors BKV nephropathy Disease recurrence Non-adherence Kidney transplant 


Compliance with ethical standards

Conflict of interest

The authors of this manuscript have no conflicts of interest to disclose.


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Copyright information

© IPNA 2018

Authors and Affiliations

  1. 1.Division of NephrologyLSU Health New Orleans and Children’s HospitalNew OrleansUSA
  2. 2.Washington University and St. Louis Children’s HospitalSt. LouisUSA

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