Transplantation of organs, tissues, peripheral blood stem cells, and bone marrow affords
many patients the opportunity for life-saving and life-altering treatment. The need for such
transplants is steadily increasing, due both to growing numbers of patients who could benefi
t from the traditional indications for transplantation, such as end-stage organ failure, and
to the more recent applications of transplantation for other clinical conditions. For patients
with end-stage organ failure, the wait list in the USA alone is now over 100,000 candidates.
This includes patients in need of kidney, pancreas, liver, heart, lung, and intestine allografts,
as well as patients waiting for multiorgan transplants, such as combined kidney/pancreas
and heart/lung transplants. Autologous or allogeneic hematopoietic stem cell transplantation
(HSCT) is a potentially curative treatment for chemotherapy-incurable hematologic
malignancies, conditions for which over 10,000 patients are diagnosed each year. Blood or
marrow transplantation also offers a potential cure for certain immunodefi ciency diseases,
such as RAG2-defi cient severe combined immunodefi ciency; for hemoglobinopathies, such
as sickle cell disease; and for some solid tumors, such as metastatic melanoma and metastatic
renal cell carcinoma. Advances are being made with the application of allogeneic HSCT in
autoimmune disorders, including systemic lupus erythematosus and multiple sclerosis, and
HSCT, in conjunction with solid organ transplantation, may offer a means to achieve a state
of transplant tolerance. One of the more dramatic and recent advances in clinical transplantation
has been the development of composite tissue transplantation that is offering patients
the opportunity for reconstructive facial and upper extremity allografts.