Review of transplantation--1999

1999 was both an exciting and a frustrating year for organ transplantation. The exciting developments in the past year include the wider use of the anti-interleukin-2 monoclonal antibodies, the introduction of sirolimus in the immunosuppression armamentarium and greater experimentation with immunosuppression regimens that spare corticosteroids and calcineurin inhibitors. The Holy Grail of transplantation, the clinical induction of tolerance, remains elusive although experimental studies will certainly propel clinical regimens in the new millennium. Xenotransplantation is not, as yet, a clinically applicable option. The organ shortage is as severe as it has ever been. Islet transplants have not replaced solid pancreas transplantation. Despite these unattained objectives, the past year has been notable for many achievements and will serve as a springboard for even more notable successes in the new millennium.