Although immunosuppressive agents are needed in the achievement of transplant organ function and the prevention of rejection, they have many side effects. The most important of these are of course increased susceptibility to opportunistic infections and malignancies. For this reason, it has been attempted to wean transplanted patients down to the minimum required immunosuppression. In our clinic it is our practice to wean patients off steroids one year post kidney transplant. In those on calcineurin inhibitors, dosing is slowly reduced following patient consent with frequent monitoring of serum creatinines. There are some patients whose antirejection medication is further reduced for various reasons. We analysed the clinical course of four such patients who were on no immunosuppression at all. The following table summarises the results of our four patients who are no longer taking any antirejection medication:

61 yr old white male				Cyclosporine
		10mnths		Azathioprine		135		2mnths
10yr old living related				Prednisone
52 yr old black male				Azathioprine		107
		8mnths						3mnths
23yr old cadaveric				Prednisone
54 yr old black male				Cyclosporine		84
		11mnths		Azathioprine				1mnth
14yr old cadaveric				Prednisone
33yr old black female				Azathioprine		64
		3mnths						6mnth
1yr old living related				Prednisone

In the non identical twin transplant, reasons for weaning immunosuppression were, non compliance in any case and Kaposi't sarcoma. It is possible to completely wean or stop anti rejection medication in stable kidney transplanted patients. This is particularly so in those where there is very good tissue matching or even in those where the transplant occurred many years previously. We have shown this to be possible in four patients by weaning immunosuppression gradually. Thus tolerance can be achieved using current medication regimens.