Article Text

Download PDFPDF
Modern renal transplantation: present challenges and future prospects
  1. J Galliford,
  2. D S Game
  1. Imperial College Kidney and Transplant Institute, Hammersmith Hospital, London, UK
  1. Dr D S Game, Department of Renal Medicine, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK;{at}


Renal transplantation offers patients with end stage renal failure improved survival and quality of life compared with dialysis. Although more transplants are being performed in the UK and elsewhere, the size of the renal transplant waiting list is increasing at a faster rate. Live donor transplantation between antibody compatible and incompatible pairs is one of the short term solutions to this; it may also be a sensible long term strategy since it affords better outcomes. Following successful transplantation, balancing the chronic and often deleterious effects of immunosuppression with chronic immune damage poses the key clinical challenge for transplant physicians today. Research efforts worldwide are focused towards immunological tolerance of transplanted organs with two main questions: first, how can we induce tolerance; and second, how can we test that it is operational? Immunosuppressive protocols vary greatly between transplant units, which may be reflected in differing patient and allograft survival.

  • nephrology
  • transplant medicine
  • renal transplantation
  • transplant surgery
  • immunosuppression
  • rejection
  • renal
  • tolerance
  • transplantation

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: DG and JG have received contributions towards the cost of attending international conferences from Astellas, Novartis, Roche and Wyeth pharmaceuticals.