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38; 95% confidence interval 0.30-0.48). Bisphosphonate use, increased cumulative duration of bisphosphonate use 1 year and increased cumulative bisphosphonate dose above the first quartile were associated with a reduced risk of graft failure, after adjustments. Bisphosphonates may improve long-term graft survival in kidney transplant recipients. Bisphosphonates may improve long-term graft survival in kidney transplant recipients. The EANO ESMO guidelines have proposed a classification of leptomeningeal metastases (LM) from solid cancer