TY - JOUR
T1 - Through a glass darkly
T2 - Seeking clarity in preventing late kidney transplant failure
AU - Stegall, Mark D.
AU - Gaston, Robert S.
AU - Cosio, Fernando G.
AU - Matas, Arthur
N1 - Publisher Copyright:
Copyright © 2015 by the American Society of Nephrology.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84924107697&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84924107697&partnerID=8YFLogxK
U2 - 10.1681/ASN.2014040378
DO - 10.1681/ASN.2014040378
M3 - Review article
C2 - 25097209
AN - SCOPUS:84924107697
SN - 1046-6673
VL - 26
SP - 20
EP - 29
JO - Journal of the American Society of Nephrology
JF - Journal of the American Society of Nephrology
IS - 1
ER -