Abstract

The prevalence of end stage renal failure (ESRD) is growing rapidly, due to the ageing of the population as well as to the increase of diabetes and cardiovascular diseases. Renal transplantation is the treatment of choice for patients with ESRD . As compared to dialysis patients, renal transplant recipients become older, have a better quality of live, and more often have a job. In addition, the costs of transplantation are far less than those of chronic dialysis treatment. Due to the shortage of post mortal kidney donors, a variety of programs for live donation have been developed. The outcome of live donor transplantation is more successful as compared to post mortal donation, especially when the recipient can be transplanted just prior to the start of hemo-dialysis. However, as compared to the normal population, the live expectancy of renal transplant patients is still less as compared to the normal population. In addition, they suffer from a significant co-morbidity such as cardiovascular events, infections and malignancies, partly mediated by the side effects of the immunosuppressive drugs. Therefore, research is warranted to minimize exposure to these drugs. The holy grail in transplantation remains to reprogram the immune system in such a way that a state of transplantation tolerance will be achieved.