Background:Patients presenting for renal transplantation are physically inactive and have low levels of exercise capacity. Exercise capacity is an independent predictor ofmortality in a number of clinical populations. Although mortality and quality of life improve after transplantation, only a few studies have reported the effects of transplantation on exercise capacity in this population. In addition, there are little studies to investigate factors that affect exercise capacity after renal transplantation. Purpose: To examine the change in exercise capacity, muscle strength, nutritional and mental status preand postrenal transplantation. Methods:BetweenDecember 2012 and July 2014, twenty four consecutive renal transplant recipients who underwent symptom-limited cardiopulmonary exercise testing (CPX) before and after 6 months of transplantation were enrolled in this study. We evaluated peak oxygen uptake (peakVO2) as an index of exercise capacity, VE–VCO2 slope as a ventilator response to exercise from CPX data. We measured grip as an upper muscle strength and knee extension torque as a lower muscle strength. Laboratory data (albumin, hemoglobinA1c: HbA1c) were evaluated as a nutritional condition. Hospital anxiety and depression scale (HADS) was used to know a mental status. Age, gender, body mass index (BMI), diabetes mellitus (DM), left ventricular ejection fraction (LVEF), hemodialysis (HD) and duration of HD, hemoglobin (Hgb) were adopted as a patients characteristics. All data were measured before and after 6 months of transplantation. The subjectswere divided into twogroups according to the change of peakVO2 from baseline to after 6 month; recovery group (RG) and non-recovery group (NRG). These indices were compared between the two groups. Patient received supervised exercise training after transplantation during hospitalization. After discharge, unsupervised home based exercise prescribed in each patients. Results: There were no significant deference between two groups (NRG vs RG) in age (53.5± 8.3 years, 49.0± 12.0 years), gender (male: 38.5%, 63.6%), BMI (22.3± 3.3 kg/m2, 22.0± 3.8 kg/m2), DM (n= 4, 3), LVEF (60.7± 11.4%, 62.3± 8.0%), HD (n= 9, 4), Hgb (11.1± 1.1 g/dl, 10.4± 1.5 g/dl). PeakVO2 changed 17.1± 4.1ml/kg/min to 16.4± 4.2ml/kg/min in NRG, 17.2± 3.8ml/kg/min to 20.4± 4.0ml/kg/min in RG. Compared with RG, lower peakVO2 (p= 0.028) and lower albumin (0.279± 0.420 g/ml, p= 0.019) were found in NRG at 6 month after transplantation. HD patients had longer duration of HD (29.0± 33.2 months, p= 0.022) in NRG. In addition, HbA1c tend to be worse (p= 0.083) in this group. Furthermore, albumin was positively correlated with peakVO2 (p= 0.020, r= 0.472) at 6 months after transplantation. In contrast, duration of HD was negatively correlated with peakVO2 (p= 0.010, r=−0.518). Conclusion(s): Poor nutritional condition (low albumin, high HbA1c) was the feature of NRG. Nutritional status might be as important as exercise to improve peakVO2 for patients with renal transplantation. Besides, duration of HD might be influence the recovery of exercise capacity. Implications: Low exercise capacity after renal transplantation might be need to combine exercise training and nutritional advice like a cardiopulmonary rehabilitation. And duration of HD is also important to predict recovery of exercise capacity in this populations.