{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T01:27:40Z","timestamp":1794014860277,"version":"4.8.0"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Determining specific causes of allograft failure allows a focus on understanding and treating these conditions. Previous studies highlight chronic antibody\u2010mediated rejection as a leading cause of late allograft failure. We sought to define causes of allograft failure in a large cohort of kidney transplant recipients across multiple centres in Australia and New Zealand, including cases previously attributed to chronic allograft nephropathy (CAN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All death\u2010censored allograft failures at 9 participating centres between 1 January 2014 to 31 December 2018 were included. Available clinical and biopsy data were reviewed and the \u201cmost likely\u201d cause assigned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 642 death\u2010censored allograft failures in the study period. Of these, 495 (77.1%) had an informative biopsy performed a median of 13.4\u2009months (IQR 2.5\u201339.1\u2009months) prior to allograft failure. Rejection of any type was the leading cause of allograft failure (47.5%), comprised chiefly of chronic antibody\u2010mediated rejection (37.4%) and chronic T\u2010cell mediated rejection (6.4%). Other leading causes were undifferentiated interstitial fibrosis and tubular atrophy (10.8%), late medical and surgical complications (8.1%) and recurrent or de novo glomerulonephritis (7.0%). Polyoma viral nephropathy and calcineurin inhibitor toxicity each contributed to &lt;2%. Causes of allograft failure previously attributed to CAN (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009419, 65.3%) had a similar distribution to the overall cohort, with 43.9% attributed to chronic antibody\u2010mediated rejection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>To prolong allograft survival, improved strategies are needed to curtail alloimmune responses. Greater understanding of the causes of undifferentiated interstitial fibrosis and tubular atrophy and potential treatments would also be of considerable benefit.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.14397","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T21:04:16Z","timestamp":1727730256000},"page":"930-940","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Defining causes of death\u2010censored kidney allograft failure: A 5\u2010year multicentre\n                    <scp>ANZDATA<\/scp>\n                    and clinical cross\u2010sectional study"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5109-165X","authenticated-orcid":false,"given":"William R.","family":"Mulley","sequence":"first","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Victoria Australia"},{"name":"Centre for Inflammatory Diseases, Department of Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter D.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2169-9087","authenticated-orcid":false,"given":"Michael G.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Auckland City Hospital  Auckland New Zealand"},{"name":"Central Northern Adelaide Renal and Transplantation Service Royal Adelaide Hospital  Adelaide Australia"},{"name":"Adelaide Medical School University of Adelaide  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1069-9487","authenticated-orcid":false,"given":"Helen L.","family":"Pilmore","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Auckland City Hospital  Auckland New Zealand"},{"name":"Department of Medicine University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Clayton","sequence":"additional","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service Royal Adelaide Hospital  Adelaide Australia"},{"name":"Adelaide Medical School University of Adelaide  Adelaide Australia"},{"name":"Australia &amp; New Zealand Dialysis and Transplant (ANZDATA) Registry  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9250-107X","authenticated-orcid":false,"given":"Melanie L.","family":"Wyld","sequence":"additional","affiliation":[{"name":"Department of Renal and Transplant Medicine Westmead Hospital  Westmead New South Wales Australia"},{"name":"School of Public Health, Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Eastern Health  Box Hill Victoria Australia"},{"name":"Eastern Health Clinical School Monash University  Clayton Victoria Australia"},{"name":"Department of Nephrology Austin Health  Heidelberg Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"van der Jeugd","sequence":"additional","affiliation":[{"name":"Department of Nephrology Flinders Medical Centre  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanduni C.","family":"Fernando","sequence":"additional","affiliation":[{"name":"Department of Nephrology Monash Medical Centre  Clayton Victoria Australia"},{"name":"Centre for Inflammatory Diseases, Department of Medicine Monash University  Clayton Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Fang\u2010Tzu","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Royal Melbourne Hospital  Parkville Victoria Australia"},{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5681-2214","authenticated-orcid":false,"given":"Sarah","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Nephrology Flinders Medical Centre  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Jahan","sequence":"additional","affiliation":[{"name":"Central Northern Adelaide Renal and Transplantation Service Royal Adelaide Hospital  Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3410-3572","authenticated-orcid":false,"given":"Wai H.","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Renal Medicine Sir Charles Gairdner Hospital  Perth Australia"},{"name":"Medical School University of Western Australia  Perth 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