Inclusion Criteria:

- Functioning kidney allograft (with estimated (e) GFR by MDRD >20) and be >6/12
post-transplantation

- Deteriorating allograft function as defined by linear regression of reciprocal
creatinine plot. Deterioration will be defined as a negative slope over at least the
preceding 3 months (with at least 6 creatinines included) with an adjusted r2 >0.35
and a p value of ≤0.05 compared to horizontal baseline. Deterioration will be
confirmed by reduction in Cockcroft-Gault (CG) eGFR over the same period (to exclude
increases in body mass as a cause of a negative slope on reciprocal creatinine plots)
OR significant proteinuria as assessed by a urine protein/creatinine ratio of ≥50

- CAN, by Banff '97 criteria, and/or transplant glomerulopathy on renal allograft
biopsy performed within 6/12 of enrolment

- Diffuse, linear C4d deposition on at least 25% of peritubular capillary (PTC) and/or
glomerular EC of renal transplant biopsy when assessed by immunoperoxidase or >50% of
PTC (alone) when assessed by immunofluorescence

Exclusion Criteria:

- Ages below 18 years of age

- Suspicion of pregnancy confirmed by positive HCG pregnancy test

- Untreated ureteric obstruction on ultrasound of allograft

- History of acute allograft rejection in preceding 3/12

- History of MI in preceding 3/12

- History of malignancy in previous 5 years (excluding tumours limited to skin)

- Symptomatic IHD

- Recipient of simultaneous pancreas/kidney transplant

- Recipient of ABO-incompatible kidney

- Recipient who underwent an HLA desensitisation procedure prior to transplantation

- Evidence, on examination of renal allograft biopsy specimen, of recurrent or de-novo
disease (except IgA deposition in absence of mesangial proliferation)

- Evidence, on examination of renal allograft biopsy specimen, of CNI toxicity IF
ACCOMPANIED by mostly supra-therapeutic CNI trough levels in the 6 month period
preceding biopsy.

- Documented allergy to mouse or chimeric human/mouse proteins

- HepBsAg+, HepBcAb+, HCV Ab+ or HIV+.