Stanford University School of Medicine and former Global Head of Transplantation Therapeutic Area (Discovery Research) and Global Head of Transplantation Translational Medicine, Novartis, AG, Basel, Switzerland

Where do you see improvements in immunosuppression for clinical organ transplantation in the near and distant future? RM: "Predictions are difficult, especially about the future" (Neils Bohr); so let's start with the past. Increasingly safe and effective immunosuppressive drug (ISD) regimens have been life saving and life-prolonging for over one million transplant recipients during the last 50 years. Without ISDs, our field would have been restricted to renal transplantation between identical twins: a brief footnote in the history of medicine. We often fail to appreciate that successful control of rejection is close to magic. Molecules we cannot see are administered to inhibit molecular pathways we cannot untangle so that an immune system we can barely comprehend does not reject highly immunogenic transplanted organs.