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In the first eleven months of the National Organ Matching and Distribution Service 455 kidney transplants were notified. A high proportion of first transplants failed within seven days of operation, probably reflecting low quality of some of the donor kidneys supplied. To improve the results of renal transplantation and to serve the increasing number of potential recipients registered with the service, as well as to obtain the optimum blood and tissue group compatibility of donor and recipient, many more kidneys are needed.