[Renal graft].
After years of pioneering research and clinical applications, renal transplantation has now moved into the era of routine practice-the first line treatment for renal failure in more than 1500 new patients each year in France. Despite this success, transplantation is not a cure, it simply replaces one disease by another-immunodepression. As a result, over the next 20 years, 60% of the recipients will undoubtedly develop cancer. In addition, the life span of a transplanted kidney is shorter than that of the recipient. Consequently most of them will require a second graft 8 to 10 years after the first. Together with the development of new innovating immunology agents such as FK 506 and mycophenolate, for example, these current facts raise the challenging question of the future for renal transplantation. Will adequation between donors and recipients be achieved? Should we develop single organ transplantation units within our current nephrology-urology structures or create multiorgan units devoted solely to transplantation? And finally, will (or perhaps when will) progress in immunology completely control the problem of organ rejection? One technical point is also of interest. Being (with orthopaedic surgery) one of the rare indications where open surgery can be expected to continue over the next 20 years, renal transplantation units will play an essential role in training future surgeons.
Benoit
G
G
Service d'Urologie, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
D006801:Humans; D007108:Immune Tolerance; D016030:Kidney Transplantation / Q000379:methods* / Q000401:mortality; D051437:Renal Insufficiency / Q000601:surgery*; D009927:Tissue and Organ Procurement
La greffe rénale.