中文摘要：

急性排斥反应是影响肾移植长期预后的重要因素。在新型免疫抑制剂应用下，急性排斥反应具有表现不典型、难治性排斥反应比例高等特点。本文从发生急性排斥反应高危因素的术前筛查与处理、急性排斥反应早期诊断方法以及对急性排斥反应的干预和免疫抑制药物合理应用、移植后感染预防等方面，综合浙江大学医学院附属第一医院肾脏病中心的临床研究结果，探讨发生急性排斥反应的高危因素、诊断和防控措施，以提高肾移植后长期存活率。

英文摘要：

Acute rejection is a predominant factor that has adverse influence on the long-term survival of renal allografts. With novel immunosuppressive agents coming into clinical use, manifestations of acute rejection are not typical and refractory rejection is increasing. In this article, we summarized the risk factors, diagnosis, and advances in treatment of acute rejection in 3 aspects ： the preoperative screening and management of risk factors for acute rejection; the methods for early diagnosis; and the rational use of immunosuppressants and prophylaxis of infection. Acute rejection management is a key to improve the long-term survival of renal grafts.