Why do long term grafts fail?

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Thumps
Posts: 1301
Joined: Thu Sep 14, 2006 3:50 pm
Location: London, England

Why do long term grafts fail?

Post by Thumps »

I know this isn't active much anymore but had a question which I wondered if anyone here had ever discussed with their nephrologists:

When you have a long term graft, why does it fail?

I'm coming up for 15 years post-tx, and painfully aware that when I had the op this was considered an optimum lifespan for the new kidney, i.e. they lasted on average about 15 years. I know that's now improved to possibly even double that, but lately I've been wondering - what is it that makes them fail? Is it something about toxicity long term of the drugs? Something physical to do with the graft? External factors like other illnesses?

Any thoughts or experiences welcome!
PKD/PLD diagnosed 1994, CKD stage 5 Oct 2007, Living Donor Kidney Transplant Dec 2008, still going strong!
wagolynn
Posts: 1357
Joined: Thu May 23, 2013 2:49 pm

Re: Why do long term grafts fail?

Post by wagolynn »

Hi Thumps,
I must admit I don't know of a single answer to this, I wondered if Ai Chat could produce an answer that covered all bases, this is what it produced.

"There are several reasons why long term kidney grafts eventually fail:
1. Chronic rejection: Despite being matched for a successful transplant, the recipient’s immune system can still recognize the transplanted organ as foreign and start to attack it. Over time, this gradual damage leads to scarring and ultimately failure of the graft.
2. Recurrent disease: If the original kidney disease that led to transplant recurs in the transplanted kidney, it can lead to gradual damage and failure of the graft.
3. Medication non-compliance: Patients need to take immunosuppressive medications for the rest of their lives after a transplant to prevent rejection. If they do not take their medications as prescribed, the immune system can attack the transplanted kidney and lead to failure.
4. Infection: Infections can occur at any time after a transplant and can damage the transplanted kidney.
5. Natural aging: Just like any other organ in the body, the transplanted kidney will age and eventually may not function as well as it did when it was first transplanted."

I think it has covered everything I have ever read on the subject.
I hope that helps or at least gives you some clues as where to start looking.
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