Predictors of Long-Term Kidney Transplant Survival: A Scoping Review

Long-term kidney transplant survival is a critical challenge in nephrology, which might be influenced by a myriad of recipient, donor, and post-transplant factors. Despite advancements in medical care, some issues, like transplant rejection and comorbidities, continue to hinder progress. This scoping review aimed to identify predictors of long-term kidney transplant survival.

Following Arksey and O'Malley's framework, this scoping review analyzed studies published between 2014 and 2025 across seven databases. Studies addressing recipient-, donor-, and post-transplant factors as predictors of long-term kidney transplant survival were included. The findings were categorized by timeframes and predicting factors, and finally, synthesized descriptively.

Overall, 37 studies were included. Key predictors of long-term survival included recipient-related factors such as age, BMI, comorbidities, and serum creatinine levels. Donor-related factors like age, HLA mismatches, and kidney quality also emerged as significant contributors. Post-transplant factors, including acute rejection episodes, use of immunosuppressive drugs, and hospital readmissions, were strongly associated with graft outcomes.

This review highlighted the multifaceted predictors of long-term kidney transplant survival, emphasizing the need for personalized management strategies. Tailored interventions targeting high-risk patients and enhanced donor selection protocols are vital for improving outcomes. Future research should focus on examining predictive algorithms to predict transplant survival.