Belatacept Compared to Tacrolimus in Deceased Donor Renal Transplant Recipients

Inclusion Criteria: * Patients must have known Epstein-Barr virus (EBV) serostatus, and that status must be positive * Adult patients ≥18 years of age, receiving a deceased donor kidney transplant at Columbia University Medical Center (CUMC) * Patients with a PRA ≤ of 50 * Primary or re-transplant candidates (no more than 5th renal transplant) * Deceased donor renal transplant recipients * Candidates eligible for rATG induction * Patients fully consented prior to transplantation * Women of reproductive age who are willing to delay pregnancy for the duration of the study and use appropriate recommended contraception Exclusion Criteria: * Seronegative or unknown EBV serologic status (due to the risk of post-transplant lymphoproliferative disorder, PTLD), predominantly involving the central nervous system. * Patients with tuberculosis who have not been treated for latent infection. * Scheduled to undergo multi-organ transplantation * Recipients of previous non-renal organ transplant * Patient receiving 5th renal transplant at the time of screening. * Patients with a PRA \> 50 * Recipient is pre-emptive status. * Recipient with positive flow crossmatch. * History or known HIV * Known hypersensitivity or contra-indications to Belatacept, Tacrolimus, Mycophenolate mofetil (cellcept), or mycophenolic acid * Use of an investigational drug in the past 30 days before day of surgery * Enrolled in a clinical trial other than the current * Lactating or pregnant women * Donor specific a…