Abstract: Objective To evaluate the correlation between the quality of donor renal grafts and graft rejection. Methods The cold ischemia time and the pathological findings by biopsies of the donor grafts in 87 cases were analyzed in conjunction with the occurrence of acute or chronic graft rejection after transplantation. Results After transplantation, acute rejection occurred in 28 cases, in which 5 (17.8%) had adverse changes in the donor grafts; chronic allograft nephropathy developed in 13 cases, in which 6 (46.1%) had adverse changes in the donor grafts. By binary logistic regression analysis, the cold ischemia time and acute renal tubular injury were identified as the factors affecting acute graft rejection, and cold ischemia time and glomerulo-serosis as the risk factors for chronic rejection. Conclusion High-quality donor kidney and minimization of the risk factors help reduce the occurrence of graft rejection after kidney transplantation.