Long-term result of conservative surgical management of the ruptured renal transplant.

Seven instances of spontaneous allograft rupture have been identified in a series of 585 renal transplants. Edema from acute rejection was the only common feature found. Prompt diagnosis and intervention were required to control hemorrhage. Criteria for conservative therapy are presented. The use of mattress sutures buttressed with Teflon pledgets and topical hemostatic agent proved successful in two-thirds of the cases. Nephrectomy was performed in one instance where the graft was grossly infected and in another case where hemorrhage could not be controlled. Five of seven patients have enjoyed long-term normal renal function.