A 70-year-old man with kidney failure secondary to diabetic kidney disease, hypertension, and coronary heart disease underwent a first, ABO-compatible living unrelated kidney transplant from his wife. He had been treated with peritoneal dialysis for 1.5 years prior to transplantation and had no history of blood transfusions. HLA mismatches were 2-2-2 (A-B-DR); both donor-specific antibodies and crossmatch testing were negative. Both the donor and the recipient tested positive for cytomegalovirus and Epstein-Barr virus IgG.