The standard immunosuppression for SPK or PTA includes induction therapy with antibodies. Maintenance therapy is mostly performed with a tacrolimus / mycophenolate mofetil combination. The usage of calcineurin inhibitors for maintenance therapy is characterized by a clear transition from cyclosporine to tacrolimus. Myfortic® vs. Cell Cept® shows beneficial effects after SPK in a large single center comparison. Corticosteroids are administered to the majority of patients; however, steroid-avoidance and steroid-withdrawal protocols are increasingly common.