Immunosuppressive treatment is a critical factor in the success of any kidney transplant surgery. Immunosuppressive medications such as Tacrolimus (Tac) have a narrow therapeutic range. This means high dose of Tac reduces the risk of acute rejection, but it also increases the odds of adverse events and nephrotoxicity [Schiff et al., 2007]. On the other hand, low dosage of Tac will increase the risk of acute rejection. Transplant physicians need find the optimum dose... the sweet spot. Currently, physicians select the initial dosage of immunosuppressive medication based on a patient’s Body Mass Index, i.e., 0.10-0.20 mg/kg per day. Then they adjust it on a daily basis by monitoring the trough concentration of Tac in the blood until it reaches therapeutic levels (i.e., 8-12 ng/ml for the first 3 months and 5-10 ng/ml for the 3-6 months post-transplan) [Jusko et al., 1995]. Dose adjustments continue until patients reach a stable therapeutic level, usually within 5-6 days. Trial-and-error has been the most common practice to determine the optimal Tac dosage [Provenzani et al., 2013]. This rule of thumb “one-size-fits-all” approach does not serve the unique needs of patients. Physicians desperately prefer to apply a personalized Tac dose for each patient at the start of immunosuppressive therapy to reduce the frequency of adjustments. Frequent adjustments of Tac dose results is worse outcomes [Whalen et al., 2017]. Achieving an early immunosuppressive therapeutic Tac level is proven to significantly decrease the risk of acute rejection by 58% [Schiff et. al, 2007]. Previous studies show that patients whome received personalized Tac dosage (based on the CYU3A5 genotype) reached therapeutic levels by day 3 compared to patients who used the BMI-guided dose (43.2% vs. 29.1%; P = 0.03). They also required fewer dose adjustments [Thervet, et al., 2010].​The need for an individualized drug management plan for kidney transplant recipients is significant and it will improve transplant outcomes for all patients. Improved transplant outcomes such as lower rejection rates, shorter hospital stays, and higher organ utilization translate into reducing the healthcare cost of kidney care. An immediate benefit of this product will be for patients with high Tac metabolism. Patients who express the homozygote alleles of CYP3A5*1 gene, tend to have higher metabolism, hence they require higher dosage of Tac. But the current method of administering Tac does not accommodate pharmacogenomic factors. Practicing personalized kidney care in centers with high portion of African American patients will drastically improve the outcome of kidney transplantation in such centers. Transplant centers currently do not have the capacity to individualize immunosuppressive dosage because the cost of gene sequencing is high and there are too many complex factors that need to be considered to select an individualized dosage. Virginia BioAnalytics has streamlined the process of collecting blood samples, sequencing the genes and producing a comprehensive personalized immunosuppressive management plan for patients.​ ​