Factors Associated With Survival of Kidney Allografts

Kidney transplantation is generally accepted as the best way for renal replacement therapy in patients with end-stage renal disease. Kidney transplant recipients could have a relatively high quality of life compared with maintenance hemodialysis. Despite the successful kidney transplant surgeries, rejection rate has still a high percentage in these patients; about 10% of them experience rejection within the first year. Knowing the high rate of complications and risk factors affecting kidney allograft survival, most of which are predictable and preventable, this issuehasbecomeincreasinglyimportant. Long‑term kidney allograft survival has not paralleled improvements made in the past three decades in short‑term survival. As mentioned in the literature, factors that may be related to short-and long-term survival are diverse and various. A main question to be answered about outcomes in kidney transplantationis which factors are associated with short- and long-term graft survival. Accumulating evidence supports that some of the accepted risk factors can be prolonged pretransplant dialysis time, pretranplant and posttransplant hypertension,the use of expanded criteria donors, higher serum levels of creatinine at the time of the first discharge, racialand ethnicdifferencesthatare relatedto thelevelof health services, underlying disease (diabetes mellitus), body mass index, age of recipients, donor type, proteinuria, sex ofrecipient and donor, and infections.