Abstract: Ｏｂｊｅｃｔｉｖｅ：To explore the clinicopathological features and allograft outcomes of patients with kidney retransplantation.
Ｍｅｔｈｏｄｏｌｏｇｙ：The clinicopathological and prognostic data of patients with kidney retransplantation from January 2013 to October 2022 in the Jinling Hospital were analyzed retrospectively.
Ｒｅｓｕｌｔｓ：A total of 38 patients with repeated renal transplantation were included, including 35 cases with second and 3 cases with third renal transplantation. The average renal survival time of the first kidney transplantation in patients with secondary renal transplantation was 83.2 months. Allograft biopsy was performed in 29 patients after secondary transplantation. The median time between the biopsy and the second renal transplantation was 31 months. The pathology of renal allografts in 21 patients after kidney retransplantation was related to transplant rejection, and 7 of the other 8 patients had recurrent and de novo glomerular disease. The median renal survival of the patients with kidney retransplantation was 66 (49,108) months, and the 1-, 3-and 5-year renal survival rates were 94.3％, 88.6％ and 60.0％, respectively. The survival time of kidney retransplantation in patients with first graft survival time≤6 months and≤1 year was significantly lower than that in patients with first transplant survival time> 6 months (P=0.016) and>1 year (P=0.049). In addition, the graft survival time of the patients whose waiting time from the first graft failure to the second transplantation was less than 1 year was significantly longer than that of the patients whose waiting time was more than 1 year (P<0.022). The survival time of the third kidney transplantation in 3 patients was 99 months, 115 months and 101 months, respectively, of which 2 patients had graft loss.
Ｃｏｎｃｌｕｓｉｏｎ：The prognosis of patients with kidney retransplantation is generally good. The short survival time of the first kidney transplantation and the longer waiting time before retransplantation are the risk factors of renal retransplantation. The main pathological types of renal retransplantation were rejection and new or recurrent glomerular diseases.

Key words: kidney retransplantation, pathology, prognosis