[Renal transplantation]

The clinical outcome of kidney transplantation worldwide is reviewed. Total number of kidney transplantations now number 411,071, and about 26,000 have been performed annually in recent years. In Japan, the total is 11,813, and about 600 to 700 have been performed annually in recent years. Graft survival is 80% at one year and 60% at five years in cadaveric renal transplantation worldwide, and 90% at one year and 70% at 5 years, respectively, in Japan. There is no difference in the graft survival rate between Japan and Western countries. However, there have been fewer kidney transplantations in Japan than in the west. Issues which should be resolved are (1) the number of kidney transplantations, especially cadaveric transplantations, should be increased enlarged; and (2) long-term graft survival rates should be improved. To improve the long-term graft survival rates, it is necessary to evaluate the mechanisms of chronic graft failure and develop new immunosuppressive therapies to eliminate rejection crises completely.