Kidney transplantation is the most effective treatment for end-stage renal disease; however, there are still some patients who are not easily matched with a donor kidney due to the presence of anti-human leukocyte antigen (HLA) antibodies in their blood, and they often have to wait for a long time or even die due to other complications. Most of these anti-HLA antibodies arise due to multiple pregnancies, repeated blood transfusions, infections, or having received a transplant, and can lead to hyperacute rejection. Therefore, these highly sensitized patients are often listed as contraindicated for kidney transplantation. The degree of sensitization of these hypersensitized recipients is currently screened by preoperative population reactive antibody (PRA) assays. High PRA results not only indicate the presence of multiple preexisting anti-HLA antibodies in the serum, but also suggest an important association with potential donor groups, and PRA assays can reflect the degree of sensitization of patients. Our group has admitted three sensitized patients with high PRA since August 2008 and successfully performed living relative kidney transplantation with satisfactory results through preoperative pretreatment. Our preliminary experience is reported below. Case 1: Male, 63 years old, underwent cadaveric transplantation in July 2003 for “chronic renal insufficiency – uremic phase”, recovered well after surgery, but developed chronic rejection and transplanted kidney failure in May 2006 and was treated with hemodialysis again. the highest value of PRA was 50% in class I and 100% in class II. Case 2: Male, 59 years old, underwent cadaveric transplantation in Beijing Chaoyang Hospital in April 2003 due to “chronic renal insufficiency – uremic phase”, after which the blood creatinine decreased insignificantly, fluctuating between 170-650umol/l. In December 2005, he underwent another cadaveric transplantation in Beijing Friendship Hospital. The highest PRA value was 48% for class I and 27% for class II. Case 3: Male, 47 years old, underwent cadaveric transplantation in November 2007 for “chronic renal insufficiency – uremic phase” in Shanxi Second Hospital, and the transplanted nephrectomy was performed after hyperacute rejection. The transplanted nephrectomy was performed. The highest PRA value was 48% for class I and 27% for class II. After detailed examination and careful preoperative preparation after admission, the patient was given a detailed preoperative and postoperative anti-rejection plan after adopting the domestic and international experience in the treatment of hypersensitivity kidney transplantation, and then renal transplantation was performed. All the operations were successful, no rejection occurred, and the serum creatinine was normal 1-3 days after the operation. No viral infection or pneumonia occurred after surgery. Through our experience, we believe that kidney transplantation in highly sensitized recipients is risky, but with adequate preparation and proper methods, success is still possible.