The purpose of this study is to explore the safety and efficacy of two different immunosuppressive regimens (sequential tacrolimus/mycophenolate mofetil [MMF] plus steroids versus tacrolimus plus MMF, following induction with daclizumab) in recipients of marginal donor kidneys.

An open, multicentre, randomized, parallel group study to compare in marginal old-for-old renal transplant patients the safety and efficacy of two treatments: sequential mycophenolate mofetil/delayed tacrolimus plus steroids vs tacrolimus plus mycophenolate mofetil, in patients requiring induction with anti-IL2 monoclonal antibody.

Elderly (≥50 years) low risk patients (PRA grade ≤50%, in the previous 6 months) receiving an allograft transplantation of marginal kidney(s) from elderly (>65 years) donors (old-for-old allocation) will be randomized to one of the following treatment arms:

Arm1: Sequential mycophenolate mofetil/tacrolimus/steroids

Arm2: Tacrolimus/mycophenolate mofetil/steroid one single dose (perioperatively)

Inclusion Criteria:

• Male or female patients minimum 60 years of age undergoing a cadaveric kidney transplant
• Patient has end stage kidney disease and is a suitable candidate for primary renal transplantation.
• Donors older than 60 years
• Female patients of child bearing age agree to practice effective birth control during the study.
• Patient has been fully informed and has given written informed consent

Exclusion Criteria:

• Patient has significant, uncontrolled, concomitant infections and/or severe diarrhoea, vomiting, or active peptic ulcer
• Patient has previously received or is receiving an organ transplant other than kidney or a kidney retransplant
• Any pathology or medical condition that can interfere with this protocol study proposal
• Other exclusion criteria apply