Abstract: Objective To investigate the instructive significance of clinico-pathological characteristics for individualized therapy of allograft nephropathy,and its outcome.Methods A retrospective study was conducted on 330 patients with transplanted kidney diseases in the First Affiliated Hospital of Henan University of Traditional Chinese Medicine.The biopsy of transplanted kidney was conducted under the guidance of ultrasonography,and the diagnosis was established according to Banff 2007 standard.According to the clinical manifestations of the patients and the pathological results of kidney transplantation,the immunosuppressive therapy regime was adjusted individually,and long-term regular follow-up was conducted to analyze the prognosis.Results Among 300 patients undergoing renal biopsy of transplanted kidneys,the puncture success rate was 100%;furthermore,after biopsy no severe complications including renal arteriovenous fistula of transplanted kidneys,massive haemorrhage and severe renal function damage were observed,and no patient died.The pathology of transplanted kidneys were diverse,and at the early stage after renal transplantation mainly included acute rejection and acute tubular necrosis.With the passage of time after kidney transplantation,chronic rejection,chronic graft nephropathy,glomerulus disease,critical changes of transplanted kidney,CsA or FK506 kidney injury and other chronic lesions were common in the pathology of transplanted kidney.Relapse and new onset of primary kidney diseases such as IgA nephropathy,focal segmental glomerulosclerosis,membranous nephropathy also accounted for a certain proportion of allograft nephropathy.Some patients had infection-related renal injury including BK virus-associated nephropathy,interstitial nephritis,etc.A few patients experienced other pathological conditions such as coagulation necrosis of transplanted kidneys,oxalate nephropathy,C1q nephropathy,and renal amyloidosis.According to different pathological types,different patients with transplanted kidney diseases were given individualized immunosuppressive therapy regimes,and the overall response was satisfactory.During follow-up,it was found 5 patients lost the follow-up,with a loss to follow-up rate of 1.52%(5/330).The incidence of renal failure was 8.31%(27/325).Six patients died,with a mortality rate of 1.82%(6/325).The remaining 292 patients had stable renal function.Conclusions The biopsy of transplanted kidneys is safe and reliable.The early biopsy of transplanted kidneys is beneficial to the correct understanding of the causes of transplanted kidney diseases,and provides important histopathological basis for the evaluation of transplanted kidney injury and the development of treatment regimes.The individualized and standardized treatment regimes based on the clinicopathological characteristics of transplanted kidneys can help improve the long-term prognosis of renal transplantation recipients.