This study indicates that (1) ATN adversely affects long-term allograft survival but not patient survival, (2) in patients with delayed function the duration of ATN does not influence allograft survival, (3) ATN kidneys with good recovery (SCR less than 3.0) do as well as immediate-function kidneys, (4) poor recovery from ATN (SCR greater than 3.0) is associated with poor long-term allograft survival and may be the result of allograft rejection during ATN, since analysis of multiple characteristics at the time of transplantation failed to discern any difference between the good- and poor-recovery groups, and (5) there are no reliable pretransplant indicators of those kidneys that will never function or be in the poorly recovered group.