As mentioned earlier, the post-transplant period can be divided into different periods, and each period has different characteristics, and the immunosuppressive regimen for different periods can be adjusted according to different characteristics, instead of being set in stone. This is also in line with the viewpoint of Yijing that things are always in constant change and can only be adapted to the needs of different periods with constant changes. 1, within 2 weeks after surgery This period is mainly to prevent the rejection of the transplanted kidney into the body, the best program during this period is tacrolimus or cyclosporine + mycophenolate ester drugs + prednisone. Some patients may also use biological agents such as ATG, Xenepe and other induction therapy to avoid rejection. This combination is currently considered to have the strongest anti-rejection effect and a low incidence of rejection, while in the early stage of humoral rejection, it is best to use the combination of tacrolimus + mycophenolate + prednisone. And rapamycin, imipramine these drugs are not suitable for the initial immunosuppressive program because of the weak anti-rejection effect. 2. 2 weeks to 6 months after postoperative renal transplantation The main problem of patients in this period is that prevention of rejection and prevention of infection need to be carried out simultaneously, especially prevention of infection. In order to achieve a level of infection-free and rejection-free development, the transplant surgeon needs to adjust the immunosuppressive drugs according to the patient’s condition, which is a skill that can only be understood. From personal experience, the Chinese population does not need to follow the doses set by foreigners, as many transplant centers can achieve better results by reducing mycophenolic acid drugs to two capsules in the morning and two capsules in the evening after 1 month postoperatively. And for some high-risk patients, especially the immunocompromised, lymphocyte counts continue to reduce patients can consider stopping mycophenolic acid drugs, replaced by imipramine, the same so that can significantly reduce the risk of infection, in this conversion process in addition to drug concentrations need to maintain a high level, which can reduce the incidence of rejection. 3, 6 months after surgery to 3 years after surgery This period of infection risk gradually reduced, mainly to prevent long-term rejection and complications, in 6 months after kidney transplantation, the patient’s condition is stable, it is recommended to do a transplanted kidney biopsy, according to the transplanted kidney biopsy can determine the level of immunosuppression, if the performance of immunosuppression is not enough, it is necessary to increase immunosuppression, and if the performance of the transplanted kidney drug toxicity, it is necessary to replace the immune The immunosuppression level can be determined based on the transplanted kidney biopsy. In this case, switching from tacrolimus to sirolimus is a better choice, and many patients can further improve the function of the transplanted kidney after changing the immunosuppression, provided that a transplanted kidney biopsy is performed. The immunosuppressive regimen during this time can be relatively stable, but during this time there may be long-term complications, such as post-transplant diabetes, and such patients can stop tacrolimus and switch to cyclosporine or sirolimus. And in patients taking imipramine in the early stage due to low immunity, at 6 months it is recommended to biopsy the transplanted kidney, and if there are signs of insufficient immunosuppression, the immunosuppressant needs to be replaced in time. To maintain the long-term functional stability of the transplanted kidney. 4. after 3 years after surgery With the extension of kidney transplantation time focus on chronic rejection of kidney transplantation and distant complications such as tumor, osteoporosis, diabetes, hypertension, coronary heart disease, hyperlipidemia and other such complications, immunosuppression during this period is adjusted according to the need of complications, certain cardiovascular complications placed cardiac stents, these patients can consider the application of rapamycin if there is no rejection, but attention should be paid to lipid levels. And patients with postoperative diagnosis of tumor can also be converted to rapamycin. In contrast, rapamycin should not be used in patients who present with protein. For patients who develop humoral rejection in the late stage of surgery, it is better to use tacrolimus + mycophenolic acid drugs, which can effectively control such rejection. 5. more than 10 years after surgery These patients are much the same as more than 3 years, except that with the extension of the transplantation time frame, kidney transplant recipients have become accustomed to the current immunosuppressive regimen, and generally do not easily change it to avoid increasing the risk, if factors such as elevated blood creatinine and proteinuria occur, the transplanted kidney biopsy is needed to adjust the immunosuppressive regimen according to the results. This is just our experience for each period after kidney transplantation to tell the characteristics of each period of drug use, but this staging is not absolute. There is no best immunosuppressive regimen, only the most appropriate one. Therefore, the highest level of using immunosuppressive agents is individualization, and this individualization is not just different for each person, but requires the use of the best regimen according to each person in different periods, so that we can achieve to maintain the best function of the transplanted kidney and avoid side effects of the organism.