Kidney Transplant Clinical Trials

• 1\. Adult men or women aged 18 to 65 years with end-stage kidney disease who are waiting for kidney transplant and require desensitization to enable safe kidney transplant.

• 2\. Cohort 1:

• A living donor who meets criteria for kidney donation based on national and local center-specific guidelines has been identified

• Highly sensitized participants with a requirement of positive flow cytometry crossmatch, resulting from at least one DSA detected using Luminex SAB during or before Screening

• A positive virtual crossmatch, using Luminex SAB (MFI ≥ 2000), obtained within 30 days of Screening and during Screening

‣ Cohort 2:

• PRA greater than or equal to 80% which is consistent with highly sensitized based on national criteria

• At least one anti-HLA antibody that is unacceptable for kidney transplantation 3. High-resolution HLA typing for both the recipient and the donor within 2 years of Screening.

• 4\. The participant is currently eligible for transplantation according to local standards if a graft becomes available upon completion of treatment with the study intervention.

• 5\. Hemoglobin ≥ 8 g/dL. 6. ANC ≥ 800/μL. 7. Absolute lymphocyte count ≥ 2000/μL or CD3 T cell count ≥ 500/μL. 8. Platelet count ≥ 75000/μL. 9. Vaccinations must be up to date in accordance with the national and local center guidance for transplant participants.

• 10\. Positive for EBV capsid IgG. 11. Testing for latent TB infection must be negative within 3 months prior to Screening. Testing should be conducted using either a purified protein derivative or an IFN-γ release assay (ie, QuantiFERON-TB or T-SPOT.TB). Participants with a positive test for latent TB infection must complete appropriate therapy for LTBI.

‣ A participant is considered eligible if he/she has a negative test for LTBI within 3 months prior to Screening, or if he/she has completed appropriate LTBI therapy prior to transplantation. Treatment for latent TB infection should follow national guidelines.

‣ 12\. Participants must be willing to be hospitalized for at least 2 weeks from the time of AZD0120 infusion and must reside within 2 hours of the hospital for an additional 2 weeks following hospital discharge.

‣ 13\. Capable of giving signed informed consent which includes compliance with the requirements and restrictions listed in the ICF and in this protocol.

‣ 14\. Contraceptive use by male and female participants should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

‣ 15\. Nonsterilized male participants who are sexually active with female partner of childbearing potential (See Appendix D for details):

‣ (a)Must agree to use one highly effective method of birth control for at least 3 years post AZD0120 infusion.

‣ (b)For participants who receive LDC but not AZD0120, the contraception time lasts from enrollment until 6 months after the last dose of LDC.

‣ (c)Must refrain from fathering a child or donating sperm within 3 years post AZD0120 infusion.

‣ (d)Female partner of a male participant must use one highly effective method of birth control for at least 3 years post AZD0120 infusion.

‣ 16\. Female participants (See Appendix D for details):

⁃ FOCBP who are sexually active with a non-sterilized male partner must agree to use one highly effective method of birth control for at least 3 years post AZD0120 infusion. For FOCBP participants who receive LDC but not AZD0120, the contraception time lasts from enrollment until 12 months after the last dose of LDC. Cessation of contraception after this point should be discussed with a responsible physician.

⁃ All FOCBP must have a negative serum pregnancy test result 3 days prior to enrollment at Screening.

⁃ Must refrain from donating ova within 3 years post AZD0120 infusion.