markdownabstract__Abstract__

Kidney transplantation is the treatment of choice for patients with end-stage renal disease. The
first successful transplantation was performed in 1954 and acceptable renal allograft survival was
achieved after introduction of azathioporine in combination with high dose of corticosteroids in the
mid sixties of the 20th century. Introduction of the immunosuppressant calcineurin inhibitor
(CNI) cyclosporin A and later on tacrolimus significantly improved the outcome of kidney graft
survival. Tacrolimus compared to cyclosporin diminished the acute rejection rate by 31% during
the first year after transplantation, and this percentage was even more reduced using anti-CD25
mAb as induction treatment [5]. This success have shifted the problem of transplantation from short
term graft survival to how to improve the long term graft survival. The 5-year allograft survival rate
in the Netherlands is 83% for deceased donor kidneys and 92% for living donor kidney transplants
(Nederlandse Transplantatie Stichting, 12th August 2013). In contrast, the overall European 5-year
graft survival is 77% and the USA 5-year graft survival is even worse, representing only 71% graft
survival.