Chronic kidney disease affects 1 in 10 Canadians with estimated costs of over $2 billion/year. This project will employ genetic technologies to: 1) reduce the risk of rejection through better donor-patient matching, 2) monitor the immune response after transplant to predict AMR, 3) enable personalized treatment with powerful drugs to prevent rejection while avoiding infection or cancer, and 4) study the legal, ethical, societal and economic considerations of introducing these strategies into clinical practice to improve quality of life and reduce health-care costs. The team will develop a program to prevent AMR and promote lifetime survival of the transplanted kidney.