Abstract: Acute kidney injury (AKI) is a primary complication of renal transplantation and is reversely proportional to the survival rate of renal transplantation. Ischemia-reperfusion injury after renal transplantation is the most important cause of AKI. Due to the shortage of donors, the use of aging kidneys from expanded criteria donors became increased and the incidence of AKI in kidney transplantation is increasing year by year, resulting in the lower rate of long-term survival of transplanted kidney. Many intervention measures to increase the survival rate of transplanted kidney have been tested so far. Klotho protein is a pleiotropic protein expressed in kidney, functions as an anti-aging factor, and may protect the kidney from ischemic injury through multiple mechanisms. Studies about the relationship between Klotho protein and AKI are present in recent years, while studies about Klotho protein relating to renal transplantation are scarce. Whether Klotho protein plays a protective role in allogeneic renal transplantation remains controversial. Studies on the roles of Klotho protein in renal transplantation and its impact on outcomes of renal transplantation are required, to explore an alternative way for the prevention of AKI in allogeneic renal transplantation.

Key words: Klotho, Acute kidney injury, Ischemia-reperfusion injury, Anti-aging, Renal transplantation, Transplant kidney injury