Significant progress has occurred over the decades in renal transplantation, mostly driven by improvements in short-term (one year) graft and patient survival. Further improvements in long-term survival have to come through improvements in long-term graft maintenance.

The multifactorial nature of chronic renal allograft loss makes specific interventions difficult. In the absence of any good tools to individualize immunosuppression to each patient, modest progress has occurred in long-term graft survival.  An individualized immunosuppression regimen based on the patients´ response to IS can contribute notably to decrease graft rejection rates and to avoid the appearance of severe adverse events.