Super long-term surviving two renal grafts with severe arteriolosclerosis and glomerulosclerosis

Two long-term renal transplant survivors, for about 20 yr, with unusual his tological features in the allograft kidney are reported. In both cases, mar ked hyalinosis was observed in the arterioles of the transplanted kidney, d espite never having been administered cyclosporine or tacrolimus. The cause remains unknown at the present time, but we think that the changes could b e multifactorial in origin, including due to aging of the graft, hypertensi on, hyperlipidemia and chronic rejection. We conclude that histological analysis of the allograft kidney must be perf ormed in long-term renal transplant survivors, in order to understand the h istological changes in the chronic phase after kidney transplantation and t o predict the prognosis of the graft.