BACKGROUND We tested the strategy of mTOR inhibitors with calcineurin inhibitor minimization in renal transplant recipients with known chronic allograft dysfunction. METHODS In this open-label, single-arm study, renal transplant patients were recruited after biopsy-confirmed chronic allograft dysfunction in the absence of acute rejection episode within 2 months, with proteinuria <0.8 g/day, a...

Remarkable progress has been made with respect to cardiac transplantation over the past 3 decades.1 Few dramas are as compelling as a successful heart transplant in a patient who otherwise would die of cardiogenic shock. Improved outcomes relate to our greater (but yet incomplete) insight into the pathophysiology of allograft rejection. Still, the transplanted heart is not normal, and it is sub...

Kidney transplantation has evolved over more than half a century and remarkable progress has been made in patient and graft outcomes. Despite these advances, chronic allograft dysfunction remains a major problem. Among other reasons, de novo formation of antibodies against donor human leukocyte antigens has been recognized as one of the major risk factors for reduced allograft survival. The typ...

Lung transplantation offers a lifesaving therapy for patients with end-stage lung disease but its availability is presently limited by low organ utilization rates donor lungs frequently excluded due to unsuitability at assessment. When does occur, recipients are then vulnerable primary graft dysfunction (PGD), multitudinous short-term complications, and chronic allograft dysfunction. The decisi...

Organ transplantation is often the unique solution for organ failure. However, rejection is still an unsolved problem. Although acute rejection is well controlled, the chronic use of immunosuppressive drugs for allograft acceptance causes numerous side effects in the recipient and do not prevent chronic allograft dysfunction. Different alternative therapies have been proposed to replace the cla...

Liver transplantation is a life-extending procedure for patients with end-stage liver disease (ESLD), post-transplant infections continue to be leading cause of morbidity and mortality. Infection risk varies over time, issues most commonly related transplant surgery nosocomial in the early period. Because increased burden immunosuppression, opportunistic become more common between 1 12 months p...

Although survival after lung transplantation has improved significantly during the last decade, chronic rejection is thought to be the major cause of late mortality. The physiologic hallmark of chronic rejection has been a persistent fall in forced expiratory volume in 1 second associated with an obstructive ventilatory defect, for which the term bronchiolitis obliterans syndrome (BOS) was defi...