This study utilized the UNOS database to assess clinical outcomes after kidney re-transplantation in patients with a history of post-transplant lymphoproliferative disease (PTLD). Among second kidney transplant patients from 2000 to 2019, 254 had history of PTLD in their first kidney transplant, whereas 28,113 did not. After a second kidney transplant, PTLD occurred in 2.8% and 0.8% of patients with and without history of PTLD, respectively (p=0.001). Over a median follow-up time of 4.5 years after a second kidney transplant, 5-year death-censored graft failure was 9.5% vs. 12.6% (p=0.21), all-cause mortality was 8.3% vs. 11.8% (p=0.51), and 1-year acute rejection was 11.0% vs. 9.3% (p=0.36) in the PTLD vs. non-PTLD groups, respectively. There was no significant difference in death-censored graft failure, mortality, and acute rejection between PTLD and non-PTLD groups in adjusted analysis and after propensity score matching. We conclude that graft survival, patient survival, and acute rejection after kidney re-transplantation are comparable between patients with and without history of PTLD, but PTLD occurrence after kidney re-transplantation remains higher in patients with history of PTLD.This article is protected by copyright. All rights reserved.