For most people today, ABO-incompatible kidney transplantation still carries the image of pronounced hyperacute rejection. However, with modern immunosuppressive therapy, hyperacute rejection will not occur within the first 24 hours. Clinical statistics in Japan show 3 cases of hyperacute rejection, but all of these occurred because the recipient was mistakenly transfused during surgery with frozen plasma of the same blood type. Delayed hyperacute rejection, occurring after the first 24 hours, is most likely to develop within 1 week post transplant. It does not manifest suddenly, but several years after transplantation. This means that humoral rejection ceases to occur after accommodation has been established. The use of evidence-based medicine to correct misconceptions in this area has proven to be meaningful. The publication of these data has made it possible to break down fixed thinking and prejudices previously regarded as fact in relation to ABO-incompatible kidney transplantation. It is believed that this will prove to be a major contribution in the future development of immunology. As these data are provided as a common resource for physicians performing transplantation procedures, it has encouraged more widespread implementation of organ transplantation.