• Composite end-point of acute rejection, graft survival and patient survival at 6-months and at 1-year [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
  

• Evaluation of renal function at 6 months and 1 year by MDRD formula, 24 hour urine collection and Glofil [ Time Frame: 12 months ] [ Designated as safety issue: Yes ]
  
• Evaluation of the incidence of treatment failures: defined as the percentage of patients that do not remain on initial therapy [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  
• Evaluation of the incidence of leukopenia, infections and malignancies [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  
• Evaluation of the incidence, severity and treatment of rejection [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  
• Evaluation of complications associated with corticosteroid therapy: bone disease, diabetes, hyperlipidemia, weight gain and hypertension [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  
• Evaluation of length of hospital stay, readmissions, and cumulative lengths of stay [ Time Frame: 24 months ] [ Designated as safety issue: Yes ]
  

Corticosteroids have been used in clinical transplantation for more than 30 years. There are many side effects of corticosteroids including significant bone disease, diabetes (elevated blood sugar levels), fluid retention and hypertension (high blood pressure), psychosis, peptic ulcer disease, hyperlipidemia (elevated lipid levels such as cholesterol and triglycerides), obesity (overweight), acne, and susceptibility to infections. It is hoped that the new generation of potent immunosuppressive medications (such as Prograf and CellCept) will permit avoidance or withdrawal of corticosteroids for the majority of patients to avoid both short- and long-term complications of corticosteroid use in kidney transplant recipients.

You will start receiving antirejection medications (thymoglobulin and steroids) while you are in the operating room before the transplant surgical procedure is completed and the rest of the doses will be given while you are on the transplant floor (Thymoglobulin is given as an intravenous infusion for a total of 3-5 doses). Regardless of which treatment group you are randomized to, you will start taking your oral (by mouth) antirejection treatment within 24 hours of the transplant. All patients will be started on three (3) oral antirejection medications:

1. If you are randomized to Group 1, you will start on 3 drugs; Prograf, CellCept and corticosteroids. However, your dose of corticosteroids will rapidly be decreased until completely eliminated by day 6 after transplant.
2. If you are randomized to Group 2, you will start on 3 drugs; Prograf, CellCept and corticosteroids. You will remain on all three drugs according to your doctors' standard of care and the corticosteroids will not be eliminated.