The past 35 years have been marked by tremendous progress in our understanding of the biologic basis for solid organ graft rejection and acceptance. Although still controversial, solid organ transplantation has become accepted as effective therapy of end-stage disease of the major thoracic and abdominal viscera. Progress has come in small increments and quantum leaps. Better control of immune suppression has been the most critical factor, but improvements in surgical techniques and technical advances, such as better donor organ harvesting and preservation, have played essential roles. The milestones in the development of successful organ transplantation and the current status and challenges are reviewed and the most promising future trends in this exciting field are discussed in this article.
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