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Related Experiment Video

Updated: Jun 23, 2026

Murine Full-thickness Skin Transplantation
07:59

Murine Full-thickness Skin Transplantation

Published on: January 2, 2017

Chronic allograft dysfunction-is there a treatment?

A C Ferreira1, H Viana, F Carvalho

  • 1Nephrology Department, Hospital de Curry Cabral, Lisbon, Portugal. karinadacostafer@hotmail.com

Transplantation Proceedings
|April 21, 2009
PubMed
Summary
This summary is machine-generated.

Chronic allograft dysfunction (CAD) is a frequent cause of kidney transplant loss. Sirolimus conversion after biopsy may improve allograft survival in patients with CAD.

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Last Updated: Jun 23, 2026

Murine Full-thickness Skin Transplantation
07:59

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Published on: January 2, 2017

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pathology

Background:

  • Renal transplant loss is primarily attributed to patient mortality and chronic allograft dysfunction (CAD).
  • Understanding the incidence of CAD and its relationship with immunosuppressive strategies is crucial for improving long-term graft survival.
  • This study investigates CAD in a cohort of kidney transplant recipients.

Purpose of the Study:

  • To determine the incidence of chronic allograft dysfunction (CAD) in kidney transplant recipients.
  • To analyze the association between allograft survival and various immunosuppressive regimens.
  • To identify potential protective agents against CAD.

Main Methods:

  • Retrospective analysis of 473 deceased donor kidney transplants with at least one allograft biopsy (1990-2007).
  • Clinical data, including age, gender, biopsy findings, and immunosuppression history, were collected.
  • Chronic allograft dysfunction (CAD) was diagnosed based on histological features such as interstitial fibrosis, chronic rejection, and transplant glomerulopathy.

Main Results:

  • CAD was observed in 177 of 473 patients and correlated with younger recipients and the development of chronic kidney disease (CKD) stage 5d.
  • C4d deposition in peritubular capillaries was more frequent in CAD patients, particularly those with chronic rejection (CR) and transplant glomerulopathy (TG).
  • Sirolimus conversion after biopsy demonstrated a protective effect on allograft survival, as did initial mycophenolate mofetil-based immunosuppression compared to azathioprine.

Conclusions:

  • Chronic allograft dysfunction (CAD) is a common histological finding in kidney transplant recipients.
  • Sirolimus conversion may be a beneficial therapeutic strategy for improving allograft survival in patients with CAD.
  • Immunosuppression modification, particularly with sirolimus, plays a significant role in managing CAD.