Current status of renal transplantation. Patient selection, results, and immunosuppression.

Renal transplantation is now well accepted as the preferred mode of renal replacement therapy for patients with end-stage renal disease. Recent advances in surgery, anesthesia, immunosuppression, and antimicrobial prophylaxis have made transplantation a more predictable clinical activity. The demand for kidneys has far outstripped the available supply in the United States, and careful selection and preparation of recipients is required to maximize the effective use of this limited resource. Newer immunosuppressive agents are on the horizon that offer promise for a further reduction in allograft rejection and decrease in post-transplant complications.