Abstract
Primary renal allograft dysfunction is defined as renal insufficiency in the immediate posttransplantation period. By definition, allografts with primary dysfunction never establish significant renal function after transplantation. In contrast, most other renal allograft dysfunction is “secondary” in that the allograft functioned for a time before a rise in serum creatinine. Secondary allograft dysfunction may occur early or late in the transplantation course and has a broad differential diagnosis that includes acute rejection, calcineurin inhibitor toxicity, BK polyoma virus infection, chronic allograft nephropathy, and the diverse spectrum of conditions that target the native kidney.
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