The return to dialysis after allograft failure is associated with increased morbidity and
mortality. This transition is made more complex by the rising numbers of patients who seek
repeat transplantation and therefore may have indications for remaining on low levels of
immunosuppression, despite the potential increased morbidity. Management strategies vary
across providers, driven by limited data on how to transition off immunosuppression as the
allograft fails and a paucity of randomized controlled trials to support one approach over …