{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T08:56:58Z","timestamp":1793696218980,"version":"4.5.1"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Although graft loss is a primary endpoint in many studies in kidney transplantation and a broad spectrum of risk factors has been identified, the eventual causes of graft failure in individual cases remain ill studied.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods.<\/jats:title>\n            <jats:p>We performed a single-center cohort study in 1000 renal allograft recipients, transplanted between March 2004 and February 2013.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results.<\/jats:title>\n            <jats:p>In total, 365 graft losses (36.5%) were identified, of which 211 (57.8%) were due to recipient death with a functioning graft and 154 (42.2%) to graft failure defined as return to dialysis or retransplantation. The main causes of recipient death were malignancy, infections, and cardiovascular disease. The main causes of graft failure were distinct for early failures, where structural issues and primary nonfunction prevailed, compared to later failures with a shift towards chronic injury. In contrast to the main focus of current research efforts, pure alloimmune causes accounted for only 17.5% of graft failures and only 7.4% of overall graft losses, although 72.7% of cases with chronic injury as presumed reason for graft failure had prior rejection episodes, potentially suggesting that alloimmune phenomena contributed to the chronic injury.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions.<\/jats:title>\n            <jats:p>In conclusion, this study provides better insight in the eventual causes of graft failure, and their relative contribution, highlighting the weight of nonimmune causes. Future efforts aimed to improve outcome after kidney transplantation should align with the relative weight and expected impact of targeting these causes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/tp.0000000000003192","type":"journal-article","created":{"date-parts":[[2020,2,24]],"date-time":"2020-02-24T05:30:57Z","timestamp":1582522257000},"page":"2557-2566","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":71,"title":["Assessing the Complex Causes of Kidney Allograft Loss"],"prefix":"10.1097","volume":"104","author":[{"given":"Elisabet","family":"Van Loon","sequence":"first","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Senev","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Histocompatibility and Immunogenetic Laboratory, Red Cross-Flanders, Mechelen, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyne","family":"Lerut","sequence":"additional","affiliation":[{"name":"Department of Imaging and Pathology, KU Leuven, Leuven, Belgium."},{"name":"Department of Pathology, University Hospitals Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Coemans","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Leuven Biostatistics and Statistical Bioinformatics Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper","family":"Callemeyn","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan M.","family":"Van Keer","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liesbeth","family":"Dani\u00ebls","sequence":"additional","affiliation":[{"name":"Histocompatibility and Immunogenetic Laboratory, Red Cross-Flanders, Mechelen, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Kuypers","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Sprangers","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium."},{"name":"Department of Microbiology and Immunology, Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Paule","family":"Emonds","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Histocompatibility and Immunogenetic Laboratory, Red Cross-Flanders, Mechelen, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten","family":"Naesens","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium."},{"name":"Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,2,20]]},"reference":[{"key":"R1-20241210","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/j.1600-6143.2010.03283.x","article-title":"Long-term renal allograft survival in the United States: a critical reappraisal.","volume":"11","author":"Lamb","year":"2011","journal-title":"Am J Transplant"},{"key":"R2-20241210","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.kint.2018.05.018","article-title":"Analyses of the short- and long-term graft survival after kidney transplantation in Europe between 1986 and 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