Purpose The TICTAC trial compared the strategy of rapid steroid weaning with either TAC monotherapy (MONO) or TAC/MMF (COMBO) therapy. We report survival at 6 year median follow-up (4-8 yrs) and investigate the survival of selected subgroups. Methods and Materials 150 patients were randomized to either the MONO or COMBO groups as previously reported. Corticosteroids were initiated at 0.6 mg/kg and discontinued by 8 weeks post-transplant. Patients continue to be followed long-term. Results The survival of the MONO and COMBO groups remains similar though not identical. The 5 and 7 year survival for MONO was 85 %, and 80 %, and 93% and 84 % with COMBO respectively (p= 0.19 logrank). The table below details multiple analyses. There was no difference in survival based on gender, use of a pre-transplant VAD, PRA ≥ 10 %, UNOS status, or crossover of assigned study group. Blacks had a non-significant trend towards worse survival in the MONO group, but not in the COMBO group. Patients with renal dysfunction on the day of transplant (serum Cr ≥1.7 ) had a survival benefit with COMBO but not with MONO therapy. Conclusions COMBO therapy is preferred in patients with serum Cr ≥1.7 on the day of transplant, or in black patients due to improved survival in the TICTAC trial. Survival vs. Group MONO SURVIVAL COMBO SURVIVAL Factor # Pts 7 Year p-value logrank # Pts 7 Year p-value logrank Female Recipient 17 86.9% 0.77 13 75% 0.63 Male Recipient 62 78.6% 0.77 57 85% 0.63 Black Race 16 65.7% 0.1854 12 100% 0.47 Non-Black Race 63 84% 0.1854 59 80% 0.47 SCr ≥ 1.7 day of transplant 10 70% 0.032 13 82% 0.315 SCr 69 82.3% 0.032 58 84.8% 0.315 VAD Pre Txp 21 84.8% 0.75 19 94.7% 0.62 No VAD Pre-Txp 58 78.6% 0.75 52 79.5% 0.62 PRA ≥ 10 % 23 90.6% 0.13 22 92.9% 0.25 PRA 56 76.3% 0.13 49 79.2% 0.25 UNOS Status 1A 45 76.3% 0.24 31 79.8% 0.22 UNOS Status 1B 30 83.3% 0.24 38 87.1% 0.22 UNOS Status 2 4 100% 0.24 2 100% 0.22 Cross-over of Treatment Group 8 crossed to COMBO 66.7% 0.54 21 crossed to MONO 80.4% 0.41 Remained with Assigned Treatment 71 remained on MONO 81.5% 0.54 50 remained on COMBO 85.5% 0.41