Immunosuppression Optimization Using The Prospera Assay In Kidney Transplant Recipients (IMPAKT)

Inclusion Criteria: * Subjects received a kidney transplant in the prior 3 months. * Subjects receiving maintenance therapy consisting of tacrolimus, mycophenolate sodium or mycophenolate mofetil, and optionally corticosteroids, at the time of enrollment. * Subjects received induction therapy comprising IL2 receptor antagonist or thymoglobulin, or received no induction therapy. * 18 years of age or older at time of signing informed consent. * Able to read, understand and provide written informed consent, and willing and able to comply with the study requirements. If the subject is unable to sign the informed consent, a legally authorized representative (LAR) can consent on behalf of the subject. * Subjects are at the site standard-of-care MPA dosage Exclusion Criteria: * Concurrent multiple solid organ or tissue transplants. * History of a previous organ transplant (aside from present kidney transplant), or cellular transplant. * DSA Positive according to local protocol, including either pre-transplant DSA positivity and de novo DSA positivity. * Any prior dd-cfDNA results ≥1.0% or ≥78cp/mL after 28 days post-transplant. * ABO Incompatible donor. * A serious medical condition that may adversely affect ability to participate in the study (e.g, current diagnosis of cancer). * Pregnancy. * Received any induction therapy other than IL2 receptor antagonist or thymoglobulin. * Receiving any maintenance immunosuppression other than tacrolimus, mycophenolate sodium or mycophenolate mofetil, and prednisone. * Currently undergoing regular dialysis. * Considered high-risk at the time of enrollment, as per the treating physician. * Planned or ongoing use of other commercially available or investigational dd-cfDNA or blood-based gene expression profile assays for rejection surveillance, through randomization.