This study retrospectively evaluated the long-term results of patients receiving a second allograft. Between November 3, 1975, and June 30, 2004, our transplantation team performed 1486 kidney transplantations. Fifty-three (3.5%) of these patients underwent re-transplantations. There were two study groups. Patients in group 1 (n = 21) underwent allograft nephrectomy, and those in group 2 (n = 32) did not. Demographic properties, rejection rates during follow-up, serum creatinine levels during the first 12 months, graft and patient survival rates, postoperative complications, time between transplantations, and HLA matchings were studied. For statistical analysis, student t and Kaplan Meier tests were used. P values less than 0.05 were accepted as statistically significant. Forty-three patients who underwent retransplantation had received kidney from living-related donors; the remaining 10 patients had received kidney from cadaveric donors. Mean blood creatinine levels for group 1 and group 2 were 1.8 mg/dL (range, 0.8-6.6 mg/dL) and 2.1 ± 1.1 mg/dL (range, 1.1-7.1 mg/dL). HLA AB and HLA DR mismatches were 1.9 ± 1.1 and 1 ± 0.6, respectively (P = 0.01). Acute rejection rates were not significantly different between group 1 (9/21 [43%]) and group 2 (12/32 [38%]) (P > 0.05). Average intervals between first and second transplantations were 62 ± 26 months in group 1 (P = 0.02) and 32 ± 11 months in group 2. Duration of hemodialysis before second transplantation was 27 ± 11 months in group 1 and 17 ± 9 months in group 2 (P = 0.04). Acute rejection rates for group 1 and group 2 were (8/21 [38%] versus 19/32 [59%]) (P = 0.01). One-, 3-, and 5-year graft survival rates for group 1 and group 2 were 83% and 89% (P > 0.05), 64% and 79% (P > 0.05), and 45% and 68% (P = 0.04), respectively. In conclusion, no advantage from graft nephrectomy before retransplantations was demonstrated. According to our results, HLA antigen typing is more important than graft nephrectomy on long-term graft survival. Additionally, the interval between first and second transplantations may have a negative correlation with second graft survival.