The primary reason for the use of induction therapy or intense immunosuppressive therapy at the time of transplant, is to avoid early acute rejection historically known to predict graft loss. Imunosuppressive agents can be classified into three categories: induction agents, maintenance therapy, and treatment for rejection. The modern therapies are designed to eliminate, or at least reduce the need for powerful anti-rejection drugs and their associated, often severe, side effects. The general surgeon or the specialist doctor will schedule the frequency of outpatient visits at the transplantation center on the basis of individual post-transplantation course of each patient. Follow-up is focused on monitoring the patient for acute rejection that is an otherwise unexplained rise in serum creatinine level of 20% to 25% and varying clinical signs of decreased urine output, weight gain, edema and cardiovascular disease, malignancy, infectious complications, usually pulmonary or urinary tract, delayed technical complications (example renal artery stenosis, lymphocele, obstruction), worsening hypertension, new-onset or poorly controlled diabetes mellitus, hyperlipidemia, excessive weight gain, fluid retention and CHF, excessive diuresis and volume contraction, and immunosuppressant management for appropriate blood levels and toxicities. Live-donor transplant recipients and zero antigen mismatched deceased donor kidney transplant recipients are considered to be at a lower risk for acute rejection. Elderly transplant recipients are at a greater risk for post-transplant complications because of an increased risk of infection, decreased immunoreactivity, and more chances of receiving a high-risk donor organ. In medical advances, it is a common treatment to select post induction therapy considering the risks of each individual based on epidemiologic and immunologic contemplations.