Establishment of strong immunosuppressive therapy and advance in postoperative care has improved the short-and mid-term outcomes of organ transplant in recent years. However, long-term allograft outcomes remain inadequate and have reached plateau due to complications of chronic rejection, infection, cancer, cardiovascular disease and unresolved issues. The challenge is to improve long-term outcomes and the expected answer to this challenge is mTOR inhibitor. Everolimus, which was developed as a derivative of sirolimus, has been approved for the prophylaxis of rejection of kidney allograft in Japan since December 2012. It has become possible to make a new immunosuppressive therapy to improve long-term outcomes.
