临床器官移植的最终目标是移植受者获得长期存活和持续的移植物功能。这就等同于获得与同年龄段正常人群同样的生存率。我们研究了移植肾存活超过10年的肾移植患者的结果。共有2202名患者入选该研究。这些超过10年的患者中，首次活体移植受者25年的患者生存率为57%；移植物生存率为43%；首次尸体肾移植的患者25年生存率为39%，移植物存活率为27%。导致移植物晚期丢失的2个主要原因是死亡（带功能）以及慢性移植物肾病（小管萎缩以及间质纤维化）。2个主要导致死亡的原因是心血管疾病（CVD）以及恶性肿瘤。对于非糖尿病的受者来说，由于CVD导致移植物带功能死亡的平均年龄为54+/-13岁；而糖尿病的患者则为53+/-7岁。而移植后20年以后的死亡率则相同：超过40%的患者有皮肤癌（非糖尿病患者的平均发病年龄为53 +/- 13岁；而糖尿病患者的平均发病年龄为49 +/- 8岁），超过10%的患者为非皮肤癌（非糖尿病患者的平均发病年龄为53 +/- 16岁；而糖尿病患者的平均发病年龄为46 +/- 9岁），超过30%的患者为CVD（非糖尿病患者的平均发病年龄为53 +/- 15岁；而糖尿病患者的平均发病年龄为47 +/- 9岁）。我们总结认为，长期存活的移植受者其发病率和早期死亡率较高。由于肾移植近期效果已大大改善，我们需要更多的关注患者的长期结果。

The ultimate goal of clinical transplantation is for the recipients to achieve long-term survival, with continuing graft function, that is equivalent to that of the age-matched general population. We studied subsequent outcome in kidney transplant recipients with 10 years of graft function. In all, 2202 kidney transplant recipients survived with graft function >10 years. For 10-year survivors, the actuarial 25-year patient survival rate for primary transplant living donor (LD) recipients was 57%; graft survival, 43%. For primary transplant deceased donor (DD) recipients, the actuarial 25-year patient survival rate was 39%; graft survival, 27%. The two major causes of late graft loss were death (with graft function) and chronic allograft nephropathy (tubular atrophy and interstitial fibrosis). The two major causes of death with function were cardiovascular disease (CVD) and malignancy. For nondiabetic recipients, the mean age at death with function from CVD was 54 +/- 13 years; for diabetic recipients, 53 +/- 7 years. By 20 years posttransplant, morbidity was common: >40% recipients had skin cancer (mean age for nondiabetic recipients, 53 +/- 13 years; for diabetics, 49 +/- 8 years), >10% had non-skin cancer (mean age for nondiabetic recipients, 53 +/- 16 years; for diabetics, 46 +/- 9 years), and >30% had CVD (mean age for nondiabetic recipients, 53 +/- 15 years; for diabetics, 47 +/- 9 years). We conclude that long-term transplant recipients have a high rate of morbidity and early mortality. As short-term results have improved, more focus is needed on long-term outcome.