© 2016 Elsevier B.V. The aim of this study is to evaluate the efficacy and safety of everolimus plus reduceddose cyclosporine compared with mycophenolate mofetil plus standarddose cyclosporine 5 years after living donor kidney transplantation. Between March 2008 and August 2009, 24 living donor kidney transplantations were enrolled in a 2-year, multicenter, randomized phase 3 study (RAD001A1202 study). 24 recipients were randomly classified into two groups and closely observed for 5 years. 13 recipients were administered steroid, reduceddose cyclosporine, everolimus and basiliximab (EVR group). 11 recipients were administered steroid, standard-dose cyclosporine, mycophenolate mofetil and basiliximab (STD group). Two groups were compared not only in graft function including estimated glomerular filtration rate (eGFR), and proteinuria, but also in adverse events such as de novo donor-specific antibody (DSA) production, rejection, newonset diabetes, hyperlipidemia, and cytomegalovirus (CMV) infection. No graft loss was identified in 5 years. The incidences of acute T cell rejection, de novo DSA production, hyperlipidemia, and newonset diabetes were similar. eGFR levels throughout the observation periods were similar. Three cases of proteinuria were identified in STD group. One case of proteinuria observed in EVR group was well controlled with angiotensin receptor blocker. Incidence of CMV infection in CMV antibodypositive recipients was significantly lower in EVR group. The safety and efficacy of reduceddose cyclosporine and everolimus protocol were similar to those of standarddose cyclosporine and mycophenolate mofetil other than for superior prevention of CMV infection.