{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T12:21:44Z","timestamp":1794313304376,"version":"4.9.0"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK114893"],"award-info":[{"award-number":["R01 DK114893"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["U01 116066"],"award-info":[{"award-number":["U01 116066"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006545","name":"National Institute on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["R01014161"],"award-info":[{"award-number":["R01014161"]}],"id":[{"id":"10.13039\/100006545","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Patients who receive a kidney transplant commonly experience failure of their allograft. Transplant failure often comes with complex management decisions, such as when and how to wean immunosuppression and start the transition to a second transplant or to dialysis. These decisions are made in the context of important concerns about competing risks, including sensitization and infection. Unfortunately, the management of the failed allograft is, at present, guided by relatively poor-quality data and, as a result, practice patterns are variable and suboptimal given that patients with failed allografts experience excess morbidity and mortality compared with their transplant-naive counterparts. In this review, we summarize the management strategies through the often-precarious transition from transplant to dialysis, highlighting the paucity of data and the critical gaps in our knowledge that are necessary to inform the optimal care of the patient with a failing kidney transplant.<\/jats:p>","DOI":"10.2215\/cjn.14620920","type":"journal-article","created":{"date-parts":[[2021,3,10]],"date-time":"2021-03-10T13:00:12Z","timestamp":1615381212000},"page":"444-451","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":74,"title":["Managing Patients with Failing Kidney Allograft"],"prefix":"10.2215","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct01921218","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5320-4435","authenticated-orcid":false,"given":"Scott","family":"Davis","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Colorado, Aurora, Colorado"},{"name":"Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York, New York"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5305-9685","authenticated-orcid":false,"given":"Sumit","family":"Mohan","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado, Aurora, Colorado"},{"name":"Division of Nephrology, Department of Medicine, Vagelos College of Physicians and Surgeons, New York, New York"},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,3]]},"reference":[{"key":"B1-20241015","article-title":"Kidney transplant program waitlisting rate as a metric to 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