Since the early days of transplantation, corticosteroids have been the mainstay of immunosuppressive regimens following transplantation. However, the use of corticosteroids has been associated with numerous side effects, including bone demineralisation, diabetes mellitus and hyperlipidaemia. In recent years, tacrolimus [Prograf] has been outperforming cyclosporin as the first choice of immunosuppressant in kidney, heart and liver transplantation. Studies presented recently at the 11th Congress of the European Society for Organ Transplantation (ESOT) [Venice, Italy; September 2003] suggest that treatment with tacrolimus enables the long-term management of transplant recipients without the need for corticosteroid therapy, and can also be cost effective compared with cyclosporin microemulsion.1,2