I am 2 months short of 3 years post kidney transplant. After transplant we started on Mycophenalate and Tacrolimus. after a few months they dropped the Mycophenalate and it was just Tacrolimus. After about a year I was started on full body exams with a dermatologist every 3 months. The very first exam had 3 biopsies and one of them turned out to be a malignant melanoma. I was switched from Tacrolimus to Sirolimus and Prednisone and had the melanoma surgically removed. There was no residual after the surgery and we have not found any more since. I did go through a pretty severe bout of actinic keratosis on my head which we cleared up with a topical cream that brought up lots of lessions which all disappeared after a month or so. No significant side effect with the switch to Sirolimus. I have also read that there are some who use Sirolimus off label as it alleged to encourage living longer.