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The results in transplantation are widely analyzed with both patient (dead or alive) and graft (functioning or not) survivals at different follow-up times. However, further information is needed about the quality of graft function, if any.

Treatment of end stage renal failure (ESRF) is achieved either by chronic dialysis (haemodialysis or peritoneal dialysis) or by renal transplantation (RTx). The advantages of RTx over dialysis include lower mortality (annual death rate about 1% for transplanted patients, compared with 14% for dialysed patients in year 1995 for France) [1], better long-term rehabilitation of patients, regular improved graft survival (we can expect about 60% at 10 years under triple therapy) and lower cost (on a 10 year basis, the cost of transplantation is 5.5 times less than the cost of hospital dialysis). All these previous demonstrations were made with global data including 85–90% of first grafts.

It is now without doubt that organ transplant recipients are prone to develop malignancies. A major role seems to be played by oncogenic viruses in these cancers. Different clinical risk factors have been sought after, mainly the type and the amount of immunosuppression. Azathioprine has been suspected to have its own oncogenic effect. More recently, reports pointed out the excessive immunosuppression achieved with long lasting use of anti-CD3 monoclonal antibodies. The actual influence of the induction protocols is still controversial and we cannot identify the patients who are at risk to eventually develop a tumour.