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In 2015, 13% of recipients of kidney transplants in the United States were repeat transplants for prior allograft failure (1). These repeat kidney transplant recipients (RKTR) have inferior graft survival and a higher risk of rejection to that of single kidney transplant recipients (SKTR) (1, 2). In spite of these risks, transplant patients benefit from a repeat transplant compared to dialysis support (3). The use of noninvasive biomarkers of allograft injury may optimize the care of RKTR. This article is protected by copyright. All rights reserved.

Repeat kidney transplant recipients with active rejection have elevated donor‐derived cell‐free DNA