[Organ transplantation. 4. Renal transplantation]

Renal transplantation is well recognized as a better modality for improving quality of life (QOL) in patients with end stage renal disease as compared with hemodialysis. The better QOL attained by renal transplantation can be maintained as far as a renal allograft functions. The results of renal transplantation have been markedly improved mainly by introducing cyclosporine (CsA), especially using regimens in which a more decreased dose of CsA is used in combination with other immunosuppressive drugs, including azathiopurine and ALG to avoid nephrotoxicity of CsA. Mortality due to a variety of complications such as infections, hepatic failure, malignancy and cardiovascular diseases aggravates the results of renal transplantation. Although the result of Kidney transplantation in Japan is as good as that observed in European countries ane the United States, a number of transplantation performed in Japan is extremely small compared with these countries. In order to increase a number of renal transplantation in Japan, all efforts aiming at promoting cadaveric kidney donation should be performed as a first priority.