Spontaneous renal allograft rupture 4 years after transplantation

Previously, the longest reported interval between clinical renal transplantation and 'spontaneous' renal allograft rupture was 170 days. We here report a case with an interval of 4 years between renal transplantation and the delayed 'spontaneous' renal allograft rupture (DSR). The aetiology appears to be a vigorous rejection confirmed by operative and pathological findings. The patient who was a cadaver donor recipient presented with pain and tenderness at the transplant site, falling haematocrit, hypotension and azotaemia. The details of this presentation are discussed and the need for immediate transplant nephrectomy is emphasized.