As short-term kidney transplant outcomes have improved, and donor and recipient demographics have shifted, the causes of allograft loss have become more complex. Late graft loss (>1 year after transplant) is often caused by >1 factor, and rejecting grafts can exhibit complex pathologies. Understanding how complex pathologies, including mixed T-cell– and antibody-mediated rejection, arise in some transplant recipients, and why other recipients tolerate their transplants long-term, is important to now improve long-term outcomes.
As short-term kidney transplant outcomes have improved, and donor and recipient demographics have shifted, the causes of allograft loss have become more complex. Late graft loss (>1 year after transplant) is often caused by >1 factor, and rejecting grafts can exhibit complex pathologies. Understanding how complex pathologies, including mixed T-cell– and antibody-mediated rejection, arise in some transplant recipients, and why other recipients tolerate their transplants long-term, is important to now improve long-term outcomes.