Conversion from ciclosporin to everolimus 4.5 months after transplantation can lead to improvements in renal function that are maintained for 3 years. These are the long-term results of the ZEUS study, which included 300 renal transplant recipients randomized to either continuing on ciclosporin or converting to everolimus after 4.5 months. At 3 years, mean estimated glomerular filtration rate was significantly higher in patients in the everolimus group than in the ciclosporin group. Although the incidence of biopsy-proven acute rejection was greater in the everolimus group, patient and graft survival were similar in the two groups.