The gold standard for ESRD is renal transplantation, a procedure that in 2014 has been performed in almost 80000 patients and in 2016 in over 85000 cases worldwide. The number of renal transplants is always lower than the one of the ESRD patients but the trend is on the rise, because of the improvement in surgical, nephrological, and immunological fields. In the last ten years, in fact, thanks to innovative technologies that help the surgical procedure, the use of newer and safer immunosuppressive drugs, and a better knowledge of the risk factors and the complications that transplant patients develop, there have been greater results in this field.

The first renal transplant dates back to the early 1950s. Since then a lot has changed in the renal transplantation world. Just to show some aspects: the surgical indication has been extended to patients that have never been taken into account for it before; old age patients with many comorbidities nowadays are considered for the donation; we are trying to optimize the use of DCD’s kidneys; preservation’s solutions and techniques, such as dynamic perfusion, have been improved so that ECD can be used with good results; thanks to new drugs and technologies we are forcing the histocompatibility barrier so that transplant between patients with ABO incompatibility or with high level of antibodies is possible; new ways of harvesting from living donors are always less invasive and more precise (laparoscopic and robotic harvesting).

These changes are happening so fast that it is hard to follow all of them.

The aim of this special issue is to show the state of the art of the most recent changes in the renal transplantation world and to know the newest trend that this wonderful and interesting field of medicine and surgery is chasing. For these reasons, we invite investigators to contribute research articles as well as review articles that address these innovations in surgical, nephrological, and immunological field as well as new proposals about renal transplantation.

Potential topics include but are not limited to the following:

• How to improve the donors’ pool: new horizons for the use of DCD, ECD, and suboptimal and living donors
• What has changed in the recipients’ selection: the importance of the comorbidity on short and long term results
• ABO incompatibility, antibodies, and other immunological factors are still a limit in the renal transplantation
• What has changed in the preservation and harvesting techniques
• What has changed in the surgical techniques and technologies
• Newest trend regarding the immunosuppressive drugs
• New trend in the anaesthetic field and in the perioperative treatments
• Clinical and instrumental follow-up of renal transplanted patients: how to lead it and which techniques to use in the light of the new knowledge