The purpose of this study is to assess whether in high-risk kidney transplant patients (patients whose previous kidney transplant failed, have a high PRA lab test result or are of African-American descent) that a combination of Rapamune with Prograf and steroids will prevent acute rejection as well as Rapamune and cyclosporine and steroids.

Inclusion criteria:

• Patients of African-American descent or patient with a history of multiple transplants and/or patients with a high panel reactive antibody lab test with a renal transplant from a cadaveric donor, a living unrelated donor or a living-related mismatched donor.
• Age >= 13 years, weight >= 40 kg
• Women must have a negative pregnancy test at study entry

Exclusion criteria

• Multiple organ transplants or double kidney transplants (pediatric en-bloc or double adult)
• Active systemic infection, or localized major infection or known HIV
• Patients with residual kidney function >20 mL/min