GraftAssure Lowering Allograft rejeCTIon by Combination- (GALACTIC) Trial

Inclusion Criteria: Prospective Participant 1. 18 years of age or older. 2. ≥ 2 weeks post-kidney transplant at the time of first sample collection. 3. Provides legally effective informed consent. 4. Agrees to comply with all study procedures. Inclusion Criteria: Historical Control Participant 1. 18 years of age or older 2. Has a minimum of three clinical evaluations per year post-transplant. Exclusion Criteria: Prospective Participant 1. Has received transplanted kidney from their identical twin. 2. Has a history of another previously transplanted organ in situ, other than a prior kidney transplant. 3. Has received an allogenic bone marrow graft or hematopoietic stem cell transplantation (HSCT). 4. Self-reports as pregnant. 5. Has a current malignancy, other than low-grade malignancy. 6. Actively enrolled in another cfDNA assay-based trial. 7. In the opinion of the investigator, participation in this study would pose a risk to data integrity or to the participant's safety and welfare. Exclusion Criteria: Historical Control Participant 1. Has received a kidney transplant from their identical twin. 2. Has a history of another previously transplanted organ in situ, excluding previous kidney transplant. 3. Has a current malignancy, other than low-grade malignancy. 4. Self-reported pregnancy during the historical data time period.