Abstract： Objective To study the immunologic and pathologic features of an accelerated rejection model of renal allotransplantation in presensitized monkeys.Methods The accelerated rejection model of renal allotransplantation was established in presensitized monkeys,which received donor skin transplantation in advance(n=3).The changes of donor specific antibody(DSA)levels in the recipient monkeys before/after skin and kidney transplantation were measured.The kidney grafts were examined for routine pathology,antibody and complement depositions,various lymphocyte subsets infiltration by HE staining,immunofluorescence,or immunohistochemistry.Results All renal allografts in 3 presensitized monkeys developed accelerated rejection within 4 days.In 2 presentized monkeys,the levels of DSA and their mediated complement-dependent cytotoxicity(CDC)were significantly increased after skin transplantation,and further markedly elevated at the time of kidney graft rejection.In the rejected renal grafts,massive C3,C4,C5b-9 and IgG deposits with few lymphocytes infiltration were found.Typical pathologic changes included severe arterionecrosis,thrombosis,interstitial hemorrhage,and infiltration of neutrophils.In the rest one presentized monkey,the levels of DSA and CDC were only marginally increased,and the pathological changes of the rejected renal graft were characterized mainly by the injury of renal tubules.Conclusion Presensitization by donor skin transplantation could elevate the levels of DSA and CDC in recipient monkeys,which resulted in severe antibody-mediated acute humoral rejection in most of the following renal transplants.