AIIM Trial: Personalized Medicine Approach to Kidney Allograft Function

Inclusion Criteria: * Adult (18 years of age or older) patients with end-stage renal disease (ESRD) * Recipient of a first or subsequent deceased donor kidney transplant * Clinical indication to receive tacrolimus as the primary immunosuppression * Willing and able to provide written informed consent to participate Exclusion Criteria: * Recipients of transplanted organs other than kidney * Recipients of a transplant from a monozygotic (identical) sibling * Human Leukocyte Antigen (HLA)-identical donor (zero out of six antigen mismatch donor) * Recipient of third or more transplant * Current or historical panel reactive antibodies of more than 50% * Blood Type (ABO) incompatibility or known moderate or strong donor specific antibodies * De novo or recurrent glomerulonephritis on 3-month biopsy * Lupus nephritis on 3-month biopsy * Focal segmental glomerulosclerosis on 3-month biopsy * BK polyomavirus nephropathy in current or prior transplant * Recipient of a bone marrow transplant * Recipient who is pregnant * Enrollment in a competing trial that would interfere with selection or alteration of immunosuppression * Inability to follow up with transplant center for up to 15 months after transplantation * Anticipated major surgery during the time of planned study * Major medical illness with life expectancy less than 15 months * Suspicion of noncompliance * Anticipated relocation to a location that would not allow follow up at local center in the next 18 months * Inability to …