*Purpose: Our study was to explore the diagnostic efficacy of Color Doppler ultrasound (CDUS) on the diagnosis of allogeneic transplanted renal artery stenosis (TRAS) during the follow-up period in allogeneic renal transplantation recipients.

*Methods: CDUS parameters and medical records of 287 patients who underwent an allogeneic renal transplantation surgery from January 2014 to December 2016 in our center were enrolled. 69 renal transplantation recipients were screened by using new CDUS thresholds from January 2017 to September 2017. At same time, following CDUS examination, all patients were scheduled for a magnetic resonance angiography (MRA) test of allogeneic transplanted renal. Diagnostic accuracy of the new criteria was calculated at this stage.

*Results: Consistent with results of MRA, a renal artery peak systolic velocity (PSV) of >250 cm/s, which was used as CDUS threshold to diagnose TRAS, showed a sensitivity of 83.3% and a specificity of 96.8%. Moreover, ratio of renal artery PSV / interlobar artery PSV (RA-to-IA) of >10 and interlobar artery resistance index (RI) presented sensitivities of 83.3% and 33.3% and specificities of 98.4% and 98.4% to diagnose TRAS, respectively.

*Conclusions: According to our findings, we suggested regular CDUS monitor aided as an early diagnosed method of TRAS in the postoperative follow-up of renal transplantation recipients. And we also proposed the diagnostic criteria of TRAS as one of the following: i) Recipients with symptoms include elevated serum creatinine or refractory hypertension; With at least one of CDUS factors: CDUS thresholds were transplant renal artery PSV >250 cm/s, PSV ratio of the RA-to-IA >10. ii) Asymptomatic recipients, existence with two CDUS factors.

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