Mycophenolate sodium vs Everolimus or Ciclosporin with Allograft Nephropathy as Outcome.

This study compares the results on changes of renal allograft histology by optimal use of ciclosporin, mycophenolate sodium and everolimus ( primary endpoints). Furthermore cardiovascular, infectious and oncologic endpoints will be assessed in each group and compared to each other.

By achieving optimal immunosuppression with minimal sideeffects due to controled drugexposure by target AUC's we expect reduction of druginduced damage on kidney and cardiovascular system. Three drugs will be subject of study: ciclosporin, mycophenolate and everolimus.

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By achieving stable state 6 months after renal transplantation a baseline renal allograft biopsy is performed and randomisation in one of the three arms of the study takes place.

Arm 1: prednisolon and AUC guided ciclosporin treatment;

Arm 2 : prednisolon and AUC guided mycophenolate mofetil sodium treatment;
Arm 3: prednisolon and AUC guided everolimus treatment. All treatment arm have a duration of 18 month whereafter a final renal allograft biopsy is performed.

It has to be noted that for the 3 treatmentarms no separate control group is defined because no data exists adressing the "golden standard" treatment after renal transplantation.