ABSTRACT
The first successful kidney transplant was performed between identical twins in 1954, ushering in over 50 years of development and innovation in the field of solid organ and bone marrow transplantation. Kidney transplantation is now considered the preferred method of renal replacement therapy worldwide, due to ever improving outcomes producing a better quality of life, and a prolongation of survival compared with dialysis.1 The major reasons leading to improved outcomes are more potent yet selective immunosuppression, better surgical techniques, and better prophylaxis and treatment of infections. In the US, there are currently about 325 000 patients receiving renal replacement therapy, with an incident rate of about 330 per million population.2 For the year 2005, there were 16 477 kidney transplants performed, 9914 from deceased donors and 6563 from live donors.3 The use of kidneys from unrelated live donors such as spouses, friends, and altruistic individuals yields outcomes similar to those from biologic relatives, and is the fastest growing donor source. The success of this procedure has created a gap of over 65 000 between the number of waiting patients and available organs.4
Currently, 1-and 5-year kidney graft survival ranges are 89-95% and 66-80%, respectively, depending on donor source.5
