*Purpose: To investigate the relationship between pretransplant biopsy and the early graft function after donated kidney transplantation.

*Methods: We examined pretransplant biopsies for 240 kidney transplant recipients from 149 deceased donors from July 2016 to April 2018. Pathological evaluation of donor kidney was made according to the Banff score(2016). The relationship between pathological results and early graft function after transplantation was analyzed retrospectively.

*Results: There was no significant correlation between glomerulosclerosis(GS) rate and delayed graft function(DGF) (p = 0.815), but GS was correlated with estimated glomerular filtration rate (eGFR) and discharged eGFR (p < 0.05).There was no significant difference(p > 0.05) between glomerulosclerosis rate less than 20% (N = 220) and more than 20% (N = 20) groups in DGF,one week eGFR and discharged eGFR. Arterial intimal fibrosis was correlated with one week eGFR and discharge eGFR (p < 0.05). One week eGFR and discharged eGFR in group that arterial intimal fibrosis score < 2 (N = 199) were significantly different from that arterial intimal fibrosis score ≥2 (N = 41) (p < 0.05). Arterial hyalinosis was correlated with one week eGFR and discharge eGFR (p < 0.05),as well as the Remuzzi scores.

*Conclusions: Studies showed that the glomerulosclerosis rate of donor kidney affects the early graft function after kidney transplantation.It is limited to judge early graft function by using 20% as a cut off of glomerulosclerosis rate. Arterial intimal fibrosis and hyalinosis were important factors affecting early eGFR after transplantation. Receptors with donor kidney Remuzzi score more than 4 had poorer early graft function after transplantation.

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