SPONTANEOUS IMPROVEMENT OF RENAL-FUNCTION FOLLOWING RENAL-ALLOGRAFT RUPTURE ASSOCIATED WITH ACUTE REJECTION

A renal allograft recipient developed acute cellular rejection 7 days after her second cadaveric renal transplantation. Her renal function failed to improve after three 0.5 g pulses of intravenous Methylprednisolone therapy. Spontaneous renal allograft rupture occurred 4 days later, which was successfully salvaged surgically. There was spontaneous rapid improvement of renal function with-marked diuresis immediately following the allograft rupture, without additional immunosuppressive therapy. Her clinical course illustrates that delayed improvement of renal allograft function can be a consequence of raised intra-renal pressure during acute rejection. In addition, intensification of anti-rejection therapy is not an absolute requirement in all cases of rejection-associated;renal allograft rupture.