The causes of kidney allograft failure: more than allo-immunity. A viewpoint paper.

Kidney allograft failure is a serious condition, as it implies the need for reinitiation of dialysis with associated morbidity and mortality, reduced quality of life, and higher economic cost. Despite improvements in short-term survival of kidney allografts, this progress was not matched in long-term graft survival. In this viewpoint article, we summarize the available literature on the causes of kidney allograft failure, both early and late, both nonimmune and alloimmune, to gain better insight into the causes of graft failure. Such insight is necessary to better target therapies or take preventative measures that improve long-term outcome after kidney transplantation.