Chronic Allograft Nephropathy (Chronic Rejection)
Although tremendous progress has been made in preventing/treating acute rejection and increasing short-term graft survival, much less progress has been made in preventing/treating chronic rejection, also now known as chronic allograft nephropathy (CAN). It is thought that both immune and nonimmune factors converge to cause CAN. There is some evidence that the risk of CAN is reduced in those on MMF compared to those taking its predecessor, azathioprine (Imuran). CAN is the most frequent cause of graft loss, and those who experience acute rejection in the first year are more likely to later develop CAN.