Transplantation has been and continues to be an Important and often life-saving treatment option for patients with end-stage organ disease. Advances in our understanding of the immunologic mechanisms of rejection have led to pharmacologic breakthroughs that are enabling unprecedented levels of success in transplantation. Today's Immunosuppressive protocols are resulting in fewer acute rejection episodes. Moreover, several of the immunosuppressive agents recently introduced have proven effective in reversing rejection considered refractory to conventional antirejection therapies. Newer monocional antibodies offer more specific immunosuppression while minimizing the incidence and severity of adverse effects often associated with immunosuppressants, especially opportunistic infections. Fewer hospitalizations for rejection and other complications, and ideally a decreased need for retransplantation, should significantly reduce healthcare costs, but the true benefit will most certainly be measured in improved patient outcomes.