Objective To analyze the clinical application of donor specific antibodies (DSAs) detected by Luminex single antigen beads,and evaluate the relationship between the presence of DSAs and renal acute rejection.Method Serum from living-relative renal recipients of 39 cases before and after transplantation was investigated using a Luminex single antigen assay.The relation between HLA mismatch and DSA development,and the impact of DSAs on renal acute rejection were analyzed.Result A total of 313 serum samples from 39 patients were tested,including 78 serum samples before transplantation and 235 after transplantation.Recipients positive for DSAs before transplantations were not included.Five recipients with no HLA mismatch did not develop DSAs.In contrast,12 developed DSAs in 34 recipients with 0-4 HLA mismatch (35.3％,12/34).Among DSAs-positive recipients,5 recipients developed acute rejection (41.7％,5/12),significantly higher than that in recipients without DSAs (7.4％,2/27),P＜0.05.Furthermore,the average MFI value of DSAs in DSAs-positive recipients with rejection was (5723.9-± 1030.5) MFI,significantly higher than that in DSAs-positive recipients without rejection (2355.2 ± 609.7) MFI,P＜0.05.The MFI values of DSAs were gradually decreased when the patients were properly treated.Conclusion HLA mismatch may increase the risk to develop DSAs.The development of DSAs leads to acute rejection.Therefore,dynamic monitoring of DSAs using Luminex single antigen beads may timely predict renal rejection.