Abstract： Objective To summarize the experience of immunosuppression with Tacrolimus (Tac)in pediatric renal transplantation.Methods Thirty-five patients aged 10-18(average 12.4±1.5)years who received a first(33 cases)or second(2 cases)adult cadaveric donor kidneys were studied.The immunosuppression with Tac,MMF and prednisone in all patients was applied to reduce μg/L)at the 3rd,6th month and first year postoperatively.There were 1 8 cases using inductive treatment of biological agents before operation.Results The 1-,3-,and 5-year graft survival rate was 100%,97.1%and 93.9%respectively,and the corresponding patient survival rate was 100%,94.1%,and 90.9%respectively.The body weight was increased by(6.6±2.2)kg,and the body height grew up by(3.7±1.1)cm during the first year post-transplantation.Totally 7 cases(7/35,20.0%)suffered from acute rejection in the first year post-transplantation,and all 7 caLses were reversed after treatment.The other main complications included hypertension(31.4%),hyperlipemia(14.3%),drug-induced hepatic injury(11.4%).pulmonaryinfection(11.4%),bone marrow suppression(5.7%),herpes zoster(2.8%)and diabetes mellitus(5.7%),without gingival hyperplasia or hypertrichosis.Conclusion Tac,MMF plus prednisone in pediatric renal transplantation was safe and effective,but more attention should be paid to dosage and administration of Tac and corticosteroids.The inductive treatment of biological agents before operation benefits to reduce acute rejection rate.