Objective To explore the causes of early allograft nephrectomy after renal transplantation.

Methods From 2008 to 2018, 20 patients with early nephrectomy were selected from Zhongshan Hospital, Fudan University. The data of graft nephrectomy time, clinical features, auxiliary examination results, and postoperative pathology results were collected, and the causes of early graft nephrectomy were analyzed.

Results The median time of allograft nephrectomy after renal transplantation in 20 patients was 9.5 (0-77) days. Color Doppler ultrasound results showed that the blood flow was sparse and the resistance index was higher in the allograft renal. Postoperative pathology showed that 10 (50%) patients had arterial or venous thrombosis in the allograft renal, 5 (25%) patients had rejection, 2 (10%) patients had hemorrhage, 2 (10%) patients, 1 (5%) patient had primary non-function of the allograft renal. Among the 20 patients, 9 patients received donation after citizen death (DCD) donor kidneys, 2 of whom were given allograft nephrectomy due to infection. The pathogens were Acinetobacter baumannii and Mucor.

Conclusions The main cause of early allograft nephrectomy is renal thrombosis and acute rejection, and infection is one of the causes of early nephrectomy for DCD kidney transplantation.