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We aimed to include all converted patients in each of the participating centers regardless of success, length of sirolimus therapy, age, type of donation, number of previous transplants, and reason for conversion to sirolimus. There were no patients excluded from this database to reduce a selection bias and address the full spectrum of all therapeutic approaches. The study was approved by the local ethics committees, and all patients provided informed consent for the scientific use of their data. Data collection included four distinct time points before initiation of http://www.selleckchem.com/products/jq1.html sirolimus. The start of sirolimus therapy marked the study baseline to establish baseline values for allograft function, proteinuria, comorbidities, and medical therapies (immunosuppressive drugs and concomitant treatments). Data collection in the first year was intended at three, six, and 12?months after initiation of sirolimus and semiannually thereafter. Due to the retrospective nature of the study, actual time points for data collection in individual patients differed from this schedule. This was appreciated by building defined time periods and calculating the days from the study baseline for each patient. The time periods were calculated in days from baseline, with the pre-conversion visits ?1Y (365?d before conversion), ?M6 (180?d before conversion), and ?M1 (30?d before conversion. Post-conversion visits were defined as M3 (days 31�C135), M6 (days 136�C270), Y1 (days 271�C547), Y2 (548�C912), Y3 (913�C1277), Y4 (1278�C1642), Y5 (1643�C2007), and >Y5 (>2008). End points were defined as patient's death and terminal allograft failure. Renal function was estimated using the abbreviated MDRD formula. Urinary protein excretion was recorded as a protein concentration in spot urine. Because each center used different units, all urinary protein concentrations were converted to the most frequently used unit (mg/L) assuming an urinary output of 2?L/d. A protein concentration of >500?mg/L was considered positive. Dipsticks were considered if no concentration was recorded. Positive dipsticks were imputed as the average protein concentration of patients with >500?mg/L proteinuria (750?mg/L), and negative dipsticks were imputed as 122?mg/L (the average protein concentration of patients