Please select the eligibility criteria that correspond to the clinical trial below.
Title: N/A
Brief Summary: Calcineurin inhibitors, such as cyclosporine and tacrolimus, have improved allograft survival in kidney organ transplantation. Indeed, they have reduced the incidence of acute rejection episodes of cadaveric allograft recipients. Although marked progression has been made in initial survival rates, long-term kidney graft survival has yet to show such encouraging results. Because CNIs are associated with adverse effects, particularly nephrotoxicity, which contribute to declining organ function and eventual graft loss. In kidney transplants, progressive allograft dysfunction has been shown to develop in as many as 94% of patients by 1 year.

Therefore, reducing or eliminating the dose of CNIs to minimize nephrotoxicity must be balanced against the maintenance of adequate immunosuppression.

Certican allows CNI dose reduction then provides renal function improvement and current PSI strategy point out that early intervention is important in managing the risk of CAN before it develops in both de novo and maintenance renal transplant recipients.

To demonstrate Certican early introduction after 1 month provides better renal function with no change of efficacy compared to standard regimen, and also prevent delayed wound healing.


Options:
A: Inclusion Criteria:

* Patient who had received a primary or secondary kidney transplant
* Patients who were willing and from whom written informed consent was obtained
* kidney allograft with a cold ischemia time (CIT) \< 30 hours
* negative pregnancy test prior to study enrollment

Exclusion Criteria:

--Multi-organ recipients

* former Graft loss due to immunological reasons
* Patients who received a kidney from a non-heart beating donor
* A-B-0 incompatible transplants
* a current Panel Reactive Antibody (PRA) level of \> 20%
* existing antibodies against the HLA-type of the receiving transplant
* a known hypersensitivity/contraindication to any of the immunosuppressants
* Use of other investigational drugs
* Patients with thrombocytopenia (platelets \< 100,000/mm³), with an absolute neutrophil count of \< 2,000/mm³ or leucopenia (leucocytes \< 3,000/mm³), or hemoglobin \< 8 g/dL
* significant mental illness
* history of malignancy during the last five years
* HIV positive
* uncontrolled hypercholesterolemia or hypertriglyceridemia
* drug or alcohol abuse
* pregnant or breast feeding women
B: Inclusion Criteria:

* Male or female patients aged over 20 years
* Patient who is judged would have the benefits of the Extended Release Tacrolimus (Advagraf®)treatment by the investigator
* Patients has given written informed consent
* Patient is a recipient of primary or recipient of primary (a living kidney transplant, a cadaveric donor.)
* Patients has received an ABO compatible donor kidney.
* Complement-dependent Cytotoxic Crossmatch: CDC) result: negative
* Female patients of child bearing potential must have a negative urine or serum pregnancy test within 7 days prior to enrollment or upon hospitalization

Exclusion Criteria:

* Patient has previously received an organ transplant other than a kidney.
* Patient has a known hypersensitivity to tacrolimus, Sirolimus (Rapamune®),Mycophenolate mofetil.
* Desensitization
* HLA-identical
* Heart Disease; Heart failure (symptom, EF \<45%)
* Lung Disease; Significant chronic obstructive pulmonary disease, restrictive lung disease
* Patient has an uncontrolled concomitant infection (including Hepatitis B, Hepatitis C) or any other unstable
* malignant tumor history in the 5years prior to enrollment. (except,squamous cell carcinoma)
* Patient has received a kidney transplant from non-heart beating donor
* Cold ischemic time \> 30hrs
* Elevated AST and/or ALT levels greater than 3 times the upper value of the normal range of the investigational site
* (ANC)\<1,500/mm3, (WBC)\<2,500/ mm3, (PLT)\<100,000/ mm3
* ATG: Anti-thymocyte globulin induction
* Medical condition that could interfere with the study objectives.
* Patient is currently taking or has been taking an investigational products in the 30 days prior to enrollment.
* Patient is currently taking or has been taking an prohibited medications in the 28 days prior to enrollment.
* Patient who is judged not to be adequate by the investigator owing to other reasons
* Patient is pregnant or lactating.
* Recipient or donor is known to be seropositive for human immunodeficiency virus.(HIV)
C: Inclusion Criteria:

* Received kidney transplant \> 6 months and \< 3 years prior to study enrollment
* Receiving immunosuppressive regimen that includes tacrolimus and mycophenolic acid
* Between 18 and 70 years of age
* Willing to provide written informed consent

Exclusion Criteria:

* Patients with an actual serum creatinine ≥ 2 mg/dl and/or eGFR≤ 40 ml/min and/or proteinuria≥ 500mg/day
* Patients who suffered from severe humoral and/or cellular rejection (≥ BANFF IIb, recurrent acute rejection or steroid resistant acute rejection in the previous years
* Patients who have severe hypercholesterolemia (\>350 mg/dL; \>9 mmol/L) or hypertriglyceridemia (\>500 mg/dL; \>8.5 mmol/L). Patients with controlled hyperlipidemia are acceptable.
* Diabetic patients
* Woman of child-bearing potential who is planning to become pregnant or is pregnant and/or lactating who is unwilling to use effective means of contraception
* Presence of psychiatric illness (i.e., schizophrenia, major depression) that, in the opinion of the site investigator, would interfere with study requirements
* Any other medical condition that, in the opinion of the site investigator based on recall or chart review would interfere with completing the study
* Receiving any investigational drug or have received any investigational drug within 30 days prior to study enrollment
D: Inclusion Criteria:

1. Males or Females aged 18\~65 years
2. De novo recipients of cadaveric, living unrelated or living related donor kidney transplants
3. Received kidney transplant from aged 10\~65years donor
4. Willing to provide written informed consent
5. Completing study visits according to study protocol

Exclusion Criteria:

1. Recipients of multiple organ transplants
2. Kidney transplant from non-heart beating cadaveric donor / organ donor after cardiac death
3. Recipients of A-B-O incompatible transplants or lymphocyte cross-match positive transplants
4. Recipients of extra-renal solid organ transplants or stem cell transplants
5. Recipient/ donor who are known to have anti-HCV, HIV or HBsAg positive
6. Diagnosed as Cancer within the past 5 years (except complete recovered squamous cell or basal cell skin cancer)
7. Drug Hypersensitivity to investigational drugs or related drugs Females are pregnant and lactating
8. Any of the following laboratory abnormalities at screening:

   * ALT, AST, ALP, total bilirubin \> 3 times the upper limit
   * ANC \< 1,500mm3 or WBC \< 2,500mm3 or platelet \< 100,000 mm3
   * Cholesterol \> 350 mg/dl or 9.0 mmol/L, TG \> 500 mg/dl or 5.6mmol/L

Answer: D