Chronic allograft failure: A disease we don't understand and can't cure?

Abstract

In summary, the diversity and complexity of factors associated with chronic allograft failure are both a promise and a burden for clinical research on this topic. The more intervention strategies are allowed to intervene in this process, the less likely it will be that a 'magic bullet' treatment is made available soon. However, even if single interventions like lowering of blood pressure do not completely prevent chronic allograft failure, they are still indicated because of their benefit for cardiovascular prognosis. Another upcoming problem is the impact of such diverse pathophysiology on the design of clinical studies. Due to the variable nature of the disease, several thousand patients will have to be enrolled in a study lasting between 2 and 4 years in order to demonstrate a 30% reduction in allograft failure rate [58]. Nonetheless, as chronic allograft failure will soon be one of the leading causes of terminal renal insufficiency, every effort should be made to prolong allograft survival.