Impact of Envarsus XR® on Kidney Biopsy Subclinical Rejection and Blood Immunologic Profile

Inclusion Criteria:

* Fluent in English able to understand and provide informed consent.
* End stage renal disease listed for primary solitary kidney transplant.
* Willing to participate in the study and comply with study requirements as evidenced by signed IRB-approved informed consent.
* Female who are of childbearing potential will be asked to use 2 different medically acceptable methods of contraception for the duration of the study and at least 1 year post-infusion.

Exclusion Criteria:

* Previously undergone organ, tissue or cell transplant
* Allergic to Tacrolimus or MMF (Cellcept)
* Chronic use of blood thinners
* Previous chronic use of glucocorticoids or other immunosuppression, or biologic immunomodulators (prescribed for the treatment of serious inflammatory disorders)
* Significant or active infection
* Diagnosed with HIV, Hepatitis B or C, Herpes simplex virus, Varicella-Zoster virus, Epstein-Barr virus
* Have or have had cancer with in the past 3 years
* Have taken part in another study that involved an investigational drug within the last 12 months.
* Have a history of delayed or abnormal wound healing
* Are pregnant or breastfeeding
* Had a transfusion within the past 3 months
* Have or plan to be receive a live vaccination (intranasal influenza measles, mumps, rubella, oral polio, yellow fever, varicella)
* Are unable or unwilling to comply with study protocol or procedures.
* Current use anticoagulation medication