Short and long-term renal transplant complications

At a glance

• The timeline organises the complications: surgical problems in the first weeks, rejection and opportunistic infection in the first year, then cancer, cardiovascular disease, metabolic disease and chronic graft injury for life.
• A rise in creatinine is the commonest problem a registrar sees. Graft rejection is usually silent, and creatinine is a late marker, so even a 15 to 20% rise deserves a structured work-up.
• The most frequent cause of graft loss is death with a functioning graft. Cancer and cardiovascular disease are the main killers.