ESTADO ACTUAL DEL TRASPLANTE RENAL EN CHILE A 58 AÑOS DEL PRIMERO; “MI VISIÓN”

This article reviews the evolution of kidney transplantation in Chile, beginning with the first successful transplant in 1966 at the University of Chile. It highlights the establishment of kidney transplant programs that predominantly used living donors between 1968 and 1994, culminating in the first combined pancreas-kidney transplant in 1994. The article reviews the historical progression of immunosuppressive therapies, detailing the switch from steroids and azathioprine to cyclosporine, which improved graft survival. Advances in immunologic moni- toring, including the Terasaki crossmatch test and the Luminex procedure, have facilitated early diagnosis of rejection. The new immunosuppressants, Tacrolimus, Rituximab, and Belatacept, which have improved prevention and management of rejection, are discussed. Graft survival rates in Chile are comparable to those in the USA, but problems related to donor recruitment and post-transplant care persist. Finally, emerging alternatives such as xenotransplantation and tissue bioengineering are explored, with challenges to overcome before their clinical application.