Spontaneous renal allograft rupture attributed to acute tubular necrosis

A renal allograft recipient receiving triple immunosuppressive therapy deve loped spontaneous allograft rupture 5 days after her second cadaveric renal transplantation. Renal biopsy showed interstitial edema with severe acute tubular necrosis (ATN). There was no evidence of acute rejection or renal v ein thrombosis. The ruptured renal graft was salvaged by an aggressive flui d resuscitation therapy and surgical hemostasis. The renal function was sat isfactory on discharge. We conclude that renal allograft rupture can be the result of interstitial edema solely attributed to ATN in the absence of gr aft rejection, The ruptured graft kidney is potentially salvageable for tho se patients whose hemodynamic status can be stabilized by appropriate suppo rtive therapy. (C) 1999 by the National Kidney Foundation, Inc.