Prognostic methods useful in assessing patients who have received a transplant and reagents that can be used to carry out those methods are provided. The inventions are based, in part, on our analysis of gene expression in renal allografts and clinical parameters, i.e., variables associated with the donor, the recipient and/or the graft. The genes that can be assessed include those encoding agents that mediate inflammation, immune activation, and cell death (we may refer to these genes as “inflammatory”, “immune” or “cytoprotective”). Surprisingly, the levels of gene expression could predict the occurrence of DGF, AR, and the quality of later graft function even when analyzed shortly after (e.g., after vascular anastomosis and tissue reperfusion). We also found that clinical parameters available at the time of transplantation correlate with decreased graft health and can be considered in combination with gene expression to evaluate a patient's risk for an adverse outcome.