In recent years usage of sirolimus in the primary immunosuppressive regimens are widening in kidney transplant recipients. In this study the clinical follow-up of the patients who have been transplanted at our center and using immunosuppressive protocols with sirolimus were reviewed. Sirolimus including primary immunosuppressive treatment protocols have been used at the Akdeniz University Organ Transplantation Center since February 12 2002. Total of 21 patients (15 male, 6 female) received sirolimus. While of the 6 patients received sirolimus + prednisolone, 7 patients received sirolimus+mycophenolate mofetil + prednisolone and 8 patients received sirolimus + cyclosporine + prednisolone. The mean age of the patients were 32.9±7.3 years and the mean posttransplantation follow-up was 13.2±4.5 months. Three patients experienced acute rejections which were treated successfully with steroids. None of the patients had either hematologic or wound healing problems. Lymphoceles developed in 8 patients. Serum creatinine level was 1.4±0.5 mg/dl at 12 months. There was a severe increase in the serum cholesterol and triglyceride levels starting from 1st month posttransplant (total cholesterol levels pretransplant and at 1st month respectively: 159.3±29.5 and 255.7±52.3 mg/dl, p=0.0001; triglyceride levels pretransplant and at 1st month respectively: 146.9±89.5 and 215.1±102.5 mg/dl, p=0.001) and despite of regular antihyperlipemic treatment those high levels were maintained for 12 months. Hundred percent graft and patient survival rates for one year for those patients who are using sirolimus are very promising. But the most important role in defining the morbidity and mortality in this group of patients is cardiovascular events and for this reason the distraction in the lipid profile has to be taken into consideration very carefully.