Abstract： Objective To investigate the effects of HLA matching on long survival of patients with kidney transplantation. Methods In 2508 cases of renal transplants, based on Ag M standard, in 0 MM-6 MM (7 groups), the effects of HLA matching on the survival rate of 1 year, 5 years and 10 years, and the incidence of renal acute rejection (AR) in renal allografts were analyzed. Results Only 7 cases had 0-missmatches, and most cases had 2 or 3 missmatches. In the group of zero antigen mismatches, the incidence of renal AR was 5 %, lower than other groups (P＜0. 01); in the group of six antigen mismatches, the incidence of AR was 23 %, obviously higher than other groups (P＜0. 01). The 1-year, 5-year and 10-year survival rate was 97 %, 90 %, 88 % in the group of zero antigen mismatches; 94 %, 86 %, 83 % in the group of one antigen mismatches; 94 %, 84 %, 82 % in the group of two antigen mismatches; 93 %,85 %, 81% in the group of three antigen mismatches; 91%, 82 %, 74 % in the group of four antigen mismatches; 90 %, 81%, 72 % in the group of five antigen mismatches; 88 %, 80 %, 70 % in the group of six antigen mismatches. Conclusion Good HLA matching can significantly reduce the incidence of AR of renal allografts and increase the survival rate. If recipients are offered to choose those with HLA antigen mismatches ≤3, it is good for the effective use of donor kidneys, the prevention of rejection, and the improvement of the transplantation results.