GUIDELINES A. Careful long-term monitoring of graft recipients is mandatory to discover signs of immunosuppressive drug toxicity, in particular nephrotoxicity. B. In the case of a discrepancy between the drug dose and signs of toxicity, then a thorough pharmacokinetic analysis should be performed. C. Cardiovascular, renal and metabolic risks and the risk of de novo malignancy must be considered in a long-term monitoring programme.