Which of the following statement(s) is/are true concerning the outcome of renal transplantation?

a. Two-thirds of all graft losses alone (without death) occur from one to six months after transplantation

b. The most common cause for graft loss after one year following transplantation is patient death

d. An acute rejection episode in a renal allograft recipient is the most important clinical event, determining both short-term and long-term graft survival

There are two ways to lose a renal allograft—graft loss alone and death of the patient regardless of the degree of graft function at the time of death. Two-thirds of all graft losses alone (without death) occur from one to six months after transplantation. Only 14% of all graft losses occur after one year. In contrast, half of the patient losses (most dying with functioning grafts) occur more than one year after transplantation. More than half the deaths are due to cardiovascular complications not related to immunosuppression but closely related to comorbid cardiovascular variables present at the time of transplantation. Less than 25% of deaths are related to immunosuppression. The period between one and six months after transplantation is the most active and crucial time in the clinical course of a patient with a renal transplant. During this time 63% of all graft losses, 22% of deaths, and 74% of all acute rejection episodes occur. An acute rejection episode in a renal allograft recipient is the single most important clinical event determining both short and long-term graft survival. The post-transplant period that begins at six months and continues to the one year mark is the quiescent time with very few influential clinical events. Only 9% of all graft losses and 9% of all acute rejection episodes occur during this time period.