1. The transfusion effect, which was apparent in 1981, disappeared in 1988, and reversed itself in 1990. In other words, for the first time, transfused patients have started to have lower graft survival rates than nontransfused patients. 2. The proportion of transfused to nontransfused patients has decreased from a ratio of 10:1 in 1981 down to 1:1 in 1990. 3. The transfusion effect in related donors has also disappeared in recent data. 4. Data revealed that HLA-A,B, and DR mismatching had no effect between 1988 and 1990. 5. A small transfusion effect continues to be seen in young recipients. 6. In earlier data, the transfusion effect was most marked in Blacks and Hispanics, but the reverse trend is now shown for these races. White recipients had exactly the same survival rates with and without transfusions. 7. Sensitization occurred more often with transfused patients who had a tendency toward slightly lower graft survival. This was true in males, females, and pregnant females. 8. Recipients who waited on dialysis for more than 2 years had slightly lower graft survival and data showed they had received more transfusions. 9. The loss of the transfusion effect occurred at both large and small centers. The centers with 1-year graft survival under 70% tended to have a transfusion effect, whereas those above 70% had either better or worse results with transfusions.