Safety Study of Calcineurin-Inhibitor-Free Immunosuppression After Liver Transplantation

Inclusion Criteria: 1. Patients undergoing primary liver transplantation. 2. Patients older than 18 years. 3. Patients with a hepatorenal syndrome. 4. Female patients of childbearing potential willing to perform a highly effective contraception during the study and 12 weeks after conclusion of study participation. 5. eGFR \< 50 ml/min at the time point of transplantation. 6. Serum creatinine levels \> 1.5 mg/dL at the time-point of transplantation. Exclusion Criteria: 1. Patients with pre-transplant renal replacement therapy \> 14 days. 2. Patients with a reason for renal impairment other than a hepatorenal syndrome. 3. Patients with a known hypersensitivity to mTOR-inhibitors. 4. Patients with a known hypersensitivity to mycophenolate acid. 5. Patients with a known hypersensitivity to anti CD 25-monoclonal antibodies. 6. Patients with platelets \< 50.000/nl prior to initiation of therapy with mTOR inhibition. 7. Patients with triglycerides \> 350 mg/dl and cholesterol \> 300 mg/dl refractory to optimal medical treatment prior to initiation of therapy with mTOR inhibition. 8. Severe systemic infections and wound-healing disturbances. 9. Multiple organ graft recipients. 10. Patients with signs of a hepatic artery stenosis directly prior to initiation of therapy with everolimus. 11. Pregnant women will not be included in the study. 12. Patients with a psychological, familial, sociologic or geographic condition potentially hampering compliance with the study protocol and follow-up schedule. 13. Patients under guardianship (e.g., individuals who are not able to freely give their informed consent).