This text, the proceedings of the 32nd International Conference on Transplantation and Clinical Immunology, held in Lyon, France, on May 25-26, 2000, addresses novel issues in terms of changing indications for transplantation in the management of organ failure, whether humans will remain the only source for organ procurement, prospects for engineering in organ replacement, and whether transplantation will remain the most appropriate approach to organ failure. Some promising treatments are approached, such as enzymic and biochemical replacement, gene therapy, tolerance induction, stem cell...