The ONE Study UK Treg Trial

Recipient Inclusion Criteria 1. Chronic renal insufficiency necessitating kidney transplantation and approved to receive a primary kidney allograft from a living donor 2. Aged at least 18 years 3. Able to commence the immunosuppressive regimen at the protocol-specified time point 4. Willing and able to participate in The ONE Study IM and HEC subprojects 5. Signed and dated written informed consent Exclusion Criteria 1. Patient has previously received any tissue or organ transplant 2. Known contraindication to the protocol-specified treatments / medications 3. Genetically identical to the prospective organ donor at the HLA loci (0-0-0 mismatch) 4. PRA grade \> 40% within 6 months prior to enrolment 5. Previous treatment with any desensitisation procedure (with or without IVIg) 6. Concomitant malignancy or history of malignancy within 5 years prior to planned study entry (excluding successfully-treated non-metastatic basal/squamous cell carcinoma of the skin) 7. Evidence of significant local or systemic infection 8. EBV-negative; serologically positive for anti-HIV-1,2; HBsAg; Anti-HBc; Anti-HCV-ab; Anti-HTLV-1,2 or syphilis (Treponema palladium) 9. Significant liver disease, defined as persistently elevated AST and/or ALT levels \> 2 x ULN (Upper Limit of Normal range) 10. Malignant or pre-malignant haematological conditions 11. Any uncontrolled medical condition or concurrent disease that could interfere with the study objectives 12. Any condition which, in the judgement of the Investigator, would place the subject at undue risk 13. Ongoing treatment with systemic immunosuppressive drugs at study entry 14. Participation in another clinical trial during the study or within 28 days prior to planned study entry 15. Female patients of child-bearing potential with a positive pregnancy test at enrolment 16. Female patients who are breast-feeding 17. All female patients of child-bearing potential UNLESS: 1. The patient is willing to maintain a highly effective method of birth control for the duration of the study 2. The career, lifestyle, or sexual orientation of the patient ensures that there is no risk of pregnancy for the duration of the study (at the discretion of the Investigator) 18. Psychological, familial, sociological or geographical factors potentially hampering compliance with the study protocol and follow-up visit schedule 19. Any form of substance abuse, psychiatric disorder, or other condition that, in the opinion of the Investigator, may invalidate communication with the Investigator and/or designated study personnel 20. Patients unable to freely give their informed consent (e.g. individuals under legal guardianship). Donor Inclusion Criteria 1. Eligible for live kidney donation 2. Aged at least 18 years 3. An ABO blood type compatible with the organ recipient 4. Willing and able to provide a blood sample for The ONE Study IM Subproject 5. Willing to provide personal and medical/biological data for the trial analysis 6. Signed and dated written informed consent. Exclusion Criteria 1\. Genetically identical to the prospective organ recipient at the HLA loci (0-0-0 mismatch) 2. Exposure to any investigational agents at the time of kidney donation, or within 28 days prior to kidney donation 3. Any form of substance abuse, psychiatric disorder, or other condition that, in the opinion of the Investigator, may invalidate communication with the Investigator designated study personnel 4. Subjects unable to freely give their informed consent (e.g. individuals under legal guardianship)