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INTRODUCTION: Powerful immunosuppressive regimens have reduced rejection risk, leading to an expanding cohort of long-term kidney transplant recipients who are likely to encounter practitioners in other specialties. SOURCES OF DATA: Key review papers and primary literature identified through searches of PubMed, Google Scholar and Medline. AREAS OF AGREEMENT: Death from cardiovascular disease and malignancy remain the chief causes of transplant loss. Risk factors and phenotypes for these differ from the general population. AREAS OF CONTROVERSY: Many guidelines for renal transplant recipients are based on extrapolation from studies on non-transplant cohorts and may not be appropriate. Emerging studies demonstrate that established interventions in the general population are less efficacious in transplant recipients. GROWING POINTS: The influence of immunosuppression on the development of complications. AREAS TIMELY FOR DEVELOPING RESEARCH: Markers to guide individualized optimal immunosuppression and predict the development of complications would allow for targeted early intervention.

Original publication




Journal article


Br Med Bull

Publication Date





117 - 134


cancer, cardiovascular, complications, kidney, long-term, malignancy, renal, transplant dysfunction, transplantation, Cardiovascular Diseases, Humans, Immunocompromised Host, Immunosuppression, Kidney Transplantation, Neoplasms, Postoperative Care, Risk Factors