Objective: To find the reasons for dysfunction in renal graft.

Methods: A total of 27 patients with failed allografted kidneys underwent transplant nephrectomy from 2001 to 2010. The patients' data were collected separately. The pathologic diagnosis was made according to the Banff 2009 standard.

Results: All the operations were successful. The pathologic reports showed that 15 cases were acute rejection complicated with other factors (1 case was infected by Bacillus tuberculosis, 2 by mold, and 1 with IgA, 6 were found thrombus in operation), 6 cases were chronic rejection complicated with other factors [2 cases were acute rejection, and 2 cases were posttransplantation lymphoproliferative disorders (PTLD)], 4 cases were end-stage renal graft, and 2 PTLD alone. A total of 13 cases were human leukocyte antigen (HLA) mismatch, of which, 11 were confirmed as rejection.

Conclusion: Rejection complicated with other factors is the most important reason for dysfunction in renal graft, such as thrombus and infection. HLA mismatch may cause the rejection. End-stage renal graft or PTLD also has an important position in the reason for nephrograft dysfunction.

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