Update on kidney transplantation: increasing clinical success, expanding waiting lists.

Short-term and long-term renal allograft survivals have improved in recent years for several reasons. Improvements in immunosuppression have reduced acute cellular rejections to about 15% to 25%. The use of erythropoietin to treat anemia allows patients to avoid transfusions, thereby reducing sensitization and hyperacute rejections. Advances in the management of cardiovascular disease and infection have also been significant factors in improved patient and allograft survival. Although living donations are helping to increase the number of transplants, their effect on rapidly growing waiting lists is relatively small.