Renal transplantation among high-risk transplant recipients is becoming more and more
common. As the incidence of end-stage renal disease is increasing the need for organ donors is also
increasing, and with the shortage of organs the use of marginal donors has increased. All these factors
impact patient and graft survival. As time has progressed the incidence of acute rejection has decreased
significantly due to improvements in immunosuppressive medications. However, even though rates of
acute rejection have decreased significantly overall patient and graft survival has not changed much
over the years. In order to fully understand the stratification of “high-risk” renal transplantation many
donor, recipient and allograft variables need to be considered.
Keywords: High-Risk, Desensitization, Rejection, Immunologic Risk, Immunosuppression, Kidney
Transplantation, Antibody-Mediated Rrejection, Crossmatch.
