Objective To evaluate the therapeutic effects and safety of initial use of antithymocyte globulin (ATG) and rapamycin during the early stage after kidney transplantation.  Methods Thirty-eight patients were enrolled during 2006 to 2007

18 in rapamycin group and 20 in control group. In rapamycin group

50 mg ATG was used 24 h before and 24 h after kidney transplantation

and triple immunosuppressive therapy (rapamycin+MMF+steroid) was applied 3 d after the operation; Control group was induced by azathioprine

and treated by triple immunosuppressive therapy [steroid+cyclosporine (or Prograf)+ MMF]. Liver function

serum creatinine

blood lipid

C reactive protein

and Hb were measured and the postoperative complications were observed.  Results There was no significant difference in liver function

serum creatinine

C reactive protein

Hb level between 2 groups 3 weeks after kidney transplantation. Serum creatinine decreased more rapidly in rapamycin group

while triglyceride and cholesterol increased. In rapamycin group

delayed wound healing occurred in 2 patients and thrombocytopenia in 1 patient. In contrast

acute rejection occurred in 3 patients and delayed graft function was found in 4 patients in control group.  Conclusion ATG induction and initial use of rapamycin is safe and can obviously decrease the incidence of acute rejection and delayed graft function after kidney transplantation.