Outcomes for paediatric transplantations have improved in the USA over the past 25 years, according to a survey of 17,446 kidney-only recipients. 10-year patient and graft survival rates were 90.5% and 60.2%, respectively, for surgeries performed in 2001 compared with 77.6% and 46.8% for those performed in 1987. Patient survival was highest in those with high panel reactive antibody scores and lowest in adolescents, those who received pretransplant dialysis and those with focal segmental glomerulosclerosis.