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 </style> <![endif]--> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Introduction: </strong>The conventional treatment of acute kidney allograft rejection consists of high-dose corticosteroids and polyclonal antibodies. We report our experience of tacrolimus rescue therapy in patients with acute rejections refractory to corticosteroids and polyclonal antibodies.</p> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Materials and Methods: </strong>A total of<strong> </strong>34 patients with a mean age of 42.3 years and clinical diagnosis of acute kidney allograft rejection underwent tacrolimus rescue therapy when treatment with corticosteroids and polyclonal antibodies failed. Kidney allograft biopsy results were available in 21 patients. All of the patients received tacrolimus, 0.1 mg twice daily, and in those who responded to the therapy after 4 to 6 months, tacrolimus was changed into cyclosporine.</p> <p class="MsoNormal" style="text-align: left; direction: ltr; unicode-bidi: embed;"><strong>Results: </strong>Pathologic examination of 21 biopsy specimens of the kidney allografts showed acute vascular rejection in 7 patients (33.3%), acute humoral rejection in 6 (28.6%), acute cellular rejection in 3 (14.3%), and accelerated acute rejection in 3 (14.3%). Twenty-six patients (76.5%) responded to rescue therapy with tacrolimus and discharged with a mean serum creatinine level of 1.4 mg/dL (range, 1.1 mg/dL to 1.7 mg/dL). Allograft nephrectomy was done in 8 patients (23.5%) because of no response to treatment of rejection, the pathology reports of which consisted of acute vascular rejection in 5 patients and extensive necrosis in 3.</p> <strong><span style="font-size: 12pt; font-family: ">Conclusion: </span></strong><span style="font-size: 12pt; font-family: ">Tacrolimus <span class="bibrecord-highlight1"><span style="font-weight: normal;">therapy</span></span> is able to salvage<strong> </strong><span class="bibrecord-highlight1"><span style="font-weight: normal;">kidney allograft</span></span>s<strong> </strong>with acute refractory <span class="bibrecord-highlight1"><span style="font-weight: normal;">rejection</span></span>. We recommend that <span class="bibrecord-highlight1"><span style="font-weight: normal;">tacrolimus</span></span> be used as an alternative to the conventional drugs used for anti<span class="bibrecord-highlight1"><span style="font-weight: normal;">rejection</span></span><strong> </strong><span class="bibrecord-highlight1"><span style="font-weight: normal;">therapy</span></span>. However, severe infectious complications as a result of overt immunosuppression must be considered.</span>