Sirolimus treatment resulted in improved immune suppression discontinuation and improved patient-reported quality of life. (A) Cumulative incidence of complete discontinuation of all systemic immune suppressive medications, with death as competing risk event. (B) SF-36 physical component score (PCS) and mental component score (MCS) changes over time. (C) FACT-BMT total score over time. (D) FACT-BMT trial outcome index (TOI) score over time. Change from baseline to day 180 was significantly greater for sirolimus vs prednisone for SF-36 PCS (P = .012) and for FACT-BMT TOI (P = .034).