Kidney transplants account for the majority of organ transplants performed in our country: 2,423 of the 3,948 transplants performed in 2004 (61.4%). Kidney transplantation improves both quality of life and life expectancy. There is a significant cost difference between one year of dialysis and one year of care for a patient with a functioning transplant, and this difference accumulates over the entire lifespan of the transplant: an additional kidney transplant represents at least ten years of dialysis avoided. The end-stage chronic kidney disease pathway has been one of the priority strategies of the French Transplant Agency (EFG) since its creation; the Biomedicine Agency has now taken over these responsibilities. Resources have been allocated to support organ procurement from deceased donors, and the pool of living donors has been expanded (Bioethics Law of August 6, 2004). The assessment we can make today demonstrates the effectiveness of the strategy established in 1998 for organ procurement from brain-dead donors. The year 2004 definitively confirms the trends observed since 2002: the implementation of the "transplant plan," with a significant strengthening of resources and the organization of procurement, has enabled the achievement of an unprecedented level of activity: 2,423 transplants in 2004 compared to 1,629 in 1994 (+48.7%) when the EFG was established. With 164 kidney transplants from living donors, 2004 also reached a historic high, but the proportion of living donors in kidney transplant activity remains low: 6.7%. The steady increase in the number of transplants from living donors, which has more than doubled since 1996, remains modest compared to most European countries and the United States. Graft survival continues to improve, with a significant cohort effect favoring the most recent cohorts of transplant recipients. (Inspired by the introduction)