Tacrolimus/Sirolimus Versus Tacrolimus/Mycophenolate Mofetil (MMF) Versus Neoral/Sirolimus in Adult, Primary Kidney Transplantation

Inclusion Criteria: * Age \>14 years * Weight \> 40 kg * Primary renal allograft: cadaveric or mismatched living donor * Negative standard cross match for T-cells * Women of childbearing potential will be required to have a negative qualitative serum pregnancy test and agree to use an adequate method of contraception throughout the study period and for 3 months after discontinuation of study medication (3yrs, 3 mos.) * Signed and dated informed consent (Parent or legal guardian must provide written consent for patients \<18 years of age) Exclusion Criteria: * Evidence of systemic infection * History of malignancy within 10 years (with the exception of localized skin cancer) * Use of any investigational drug or treatment up to 4 weeks prior to enrolling in the study and during the 12-month treatment phase * Concurrent use of astemizole, pimozide, cisapride, terfenadine, or ketoconazole * Known hypersensitivity to sirolimus and its derivatives * Patients with a screening/baseline (or within 96 hours of transplant) * total white blood cell count \< 4000/mm3; * platelet count \< 100,000/mm3; * fasting triglycerides \> 400 mg/dl (\> 4.6 mmol/L); * fasting total cholesterol \> 300 mg/dl (\> 7.8 mmol/L); * fasting HDL-cholesterol \< 30 mg/dl; * fasting LDL-cholesterol \> 200mg/dl