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[Progress in transplantation surgery--current status: kidney transplantation, recurrence of the primary illness and kidney transplantation].

Although there are numerous reasons for organ loss following transplantation, the recurrence of underlying disease plays a major role. Focal segmental glomerulosclerosis and mesangioproliferative glomerulonephritis are leading causes. Especially in children, hemolytic uremic syndrome (HUS) is a wide concern. If recurrence occurs, there is a high chance of graft loss within the next one to two years. Therapeutic options are minimal and focus on symptomatic relief of the ongoing vascular processes. Only metabolic causes may be treated by a combined transplantation, e.g., kidney plus liver in oxalosis and kidney plus pancreas in diabetes mellitus. Prospective therapeutic studies are required to solve part of the problem.