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DOI: 10.1177/1522162802005002005 © 2002 SAGE Publications Determinants of Long-Term Graft and Patient Survival after Transplantation of Kidney and Liver
Chronic graft dysfunction leads to reduced allograft survival and is associated with reduced life expectancy after liver and kidney transplantation. Chronic rejection of the allograft, recurrence of the underlying disease in the graft, ischemia/reperfusion injury of the graft, cytomegalovirus (CMV) infection, CMV disease after transplantation, and factors associated with the organ donor have an impact on the development of chronic graft dysfunction and patient survival following kidney and liver grafting. Common side effects of immunosuppressive therapy after transplantation include acknowledged risk factors for deteriorating allograft function, as well as an elevated risk for the development of malignancies and opportunistic infections, whereas lack of compliance to immunosuppression usually leads to graft loss. With improved overall results after kidney and liver transplantation, the comorbidity of the allograft recipient becomes an increasingly important factor for the long-term prognosis after transplantation. Living-related and living-unrelated kidney donations are associated with improved graft and patient survival after renal transplantation. In this article, the authors review the current knowledge about the factors that have been implicated in the pathogenesis of chronic graft dysfunction, as well as allograft and patient survival.
Key Words: chronic allograft dysfunction • survival • kidney transplantation • liver transplantation
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