This volume is based on a very successful meeting on organ transplantation that was held in Kuwait in 1990 under the auspices of the Middle East Society for Organ Transplantation. An international group of organ transplant experts attended this conference and their contributions and deliberations have been recent1y updated to produce this definitive and authoritative summary of current clinic al practice in organ transplantation. The initial chapters appropriately focus on the immunology of organ trans plantation with special emphasis on the initial events in the induction of alloreactivity, the mechanisms of rejection, and the potential for tolerance induction. A strong emphasis is placed on the diagnosis of rejection by cellular analysis. The section on immunosuppression deals with several new areas of clinical therapy. The section on renal transplantation is unique in several respects, the long-term results from various countries, including the Middle East, are summarized, the use of living unrelated donors and of ABO incom patible donors - all strategies to maximize organ availability - are presented."

MICHAEL F.A. WOODRUFF Emeritus Professor of Surgery, University of Edinburgh This book grew out of a very successful conference on Organ Transplantation held in Kuwait in December 1982. The material presented at the conference has been expanded and brought up to date, and the result is a well written and authoritative account of many aspects of organ transplantation by a distinguished team of contributors drawn from many countries. A unique feature of the book is the account it contains of the development of organ transplantation in the Middle East. Although, as yet, it has been virtually impossible in Islamic countries to take organs after death for use as transplants, it is beginning to look as if this situation may change. Meanwhile, using living volunteer donors and a small number of cadaveric organs sent from other countries, transplant teams in Kuwait and Turkey are obtaining results with kidney transplants which are as good, in terms of both transplant survival and patient survival, as those reported from acknowledged centres of excellence in the United States, Europe and other countries where organ transplantation has been established for many years.

One: Historical Reflections.- 1. Reflections on the development of organ transplantation.- Two: Immunology of Organ Transplantation.- 2. Cellular and molecular mechanisms of allograft rejection.- 3. What does the alloreactive T cell see?.- 4. HLA matching and organ transplantation.- 5. An effective strategy for transplantation of highly sensitized patients.- 6. Rapid lymphocyte crossmatching for renal transplantation.- Three: Organ Allograft Rejection.- 7. Fifteen-year experience with fine needle aspiration biopsies at the University of Helsinki.- 8. Study of antibody specificity in highly sensitized patients using human monoclonal antibody technology.- 9. Idiotypic-Antiidiotypic antibody interaction and renal transplant survival.- Four: Immunosuppression.- 10. Transplantation and blood transfusion in 1990.- 11. Quadruple-drug immunosuppressive induction treatments for immunological high-risk patients in cadaveric renal transplantation using poly-and monoclonal antibodies.- 12. Sequential combination immunotherapy for cadaveric renal transplantation: OKT3 versus rabbit ATG induction.- 13. Multi-organ transplant experience with OKT3 and strategies for use at the University of Cincinnati Medical Center.- 14. Cyclosporine withdrawal in renal transplant recipients maintained on azathioprine, prednisone and cyclosporine.- 15. Early experience with FK 506 in liver transplantation.- 16. Deoxyspergualin. A novel immunosuppressant: experimental and clinical studies.- 17. Preliminary results with FK 506 in pancreas grafting in a nonhuman primate model.- 18. The effect of DST on graft outcome - the Turkish experience.- 19. Induction of specific unresponsiveness (tolerance) to experimental and clinical allografts using polyclonal antilymphocyte serum and donor-specific bone marrow.- 20. Comparison of cyclosporine assays using radioimmunoassay, fluorescent polarization immunoassay and high-performance liquid chromatography.- Five: Renal Transplantation.- 21. Long-term outcome in renal transplantation.- 22. Ten-year experience with 500 renal transplants.- 23. Long-term results in recipients of cadaveric renal allografts under cyclosporine therapy.- 24. Transplantation of single and double kidneys from pediatric donors.- 25. ABO-incompatible living related donor transplantation.- 26. The use of single pediatric cadaver kidneys for transplantation into adult recipients.- 27. Living unrelated donor renal transplantation.- 28. Renal transplantation in Tunisia - a three-year experience.- 29. Renal transplantation in children.- 30. Kidney donors - long-term follow up.- 31. Current techniques for permanent vascular access surgery - experience with 930 procedures.- 32. Results of 319 consecutive renal transplants from living related and living unrelated donors in Iran.- Six: Liver Transplantation.- 33. Liver transplantation: current status.- 34. An overview of liver transplantation therapy for children.- 35. Current anesthetic management in clinical liver transplantation.- 36. Risk factors in adult liver transplant recipients.- 37. The concept of reduced-size liver transplantation, including split-liver and living related liver transplantation.- 38. Immunological factors contributing to outcome in liver transplantation.- 39. Transplantation for hepatobiliary malignancies.- 40. The diagnosis and management of massive blood loss during liver transplantation.- 41. Early clinical experience with cluster resection and transplantation for right upper quadrant abdominal malignancy.- Seven: Heart/Heart-Lung Transplants.- 42. Lung transplantation: current techniques and outcomes.- 43. Heart-lung transplantation at the University of Minnesota.- 44. Specificity and sensitivity of the cytoimmunological monitoring (CIM): differentiation between cardiac rejection, viral, bacterial, or fungal infection.- Eight: Pancreas Transplantation.- 45. International Pancreas Transplantation Registry report.- 46. Techniques and experience of pancreatic transplantation wit...