Objective To identify symptoms and symptom clusters in kidney transplant recipients staying at home, to explore the influencing factors of symptom clusters, and to provide reference for postoperative symptom management. Methods Totally, 224 kidney transplant recipients staying at home were selected using convenience sampling and completed a battery of questionnaires including the Chinese Version of Modified Transplant Symptom Occurrence and Symptom Distress Scale,Perceived Social Support Scale, Fear of Progression Questionnaire, and Kidney Transplant Self-management Scale. Exploratory factor analysis was applied to extract symptom clusters, and multiple linear regression analysis was used to determine factors affecting the symptom clusters. Results The 5 most prevalent symptoms were fatigue (83.48%), trembling hands (79.02%), mood swings (75.45%), concentration difficulties (75.45%) and anxious/nervous (74.11%). Exploratory factor analysis identified five symptom clusters: psycho-cognitive-vigor-related,energy-deficient, discomfort, immune-related, and hormone-related.Self-management behavior and fear of disease progression were independent predictors of 5 symptom clusters (P＜0.05, P＜0.01). Conclusion Kidney transplant recipients staying at home suffer from various symptoms. Medical staff should pay attention to symptom management of kidney transplant recipient staying at home,strengthen their self-management awareness, and alleviate fear of progression, thus to improve their quality of life.