Renal Allograft Recovery Subsequent to Apparent “Hyperacute” Rejection Based on Clinical, Scintigraphic, and Pathologic Criteria

An unusual case is described in which in spite of clinical, scintigraphic and histologic findings strongly supportive of a diagnosis of “hyperacute rejection,” recovery of renal function occurred. These findings are in contrast to the current literature in which it is generally accepted that a renal allograft showing neither pertechnetate transit nor hippurate concentration warrants allograft nephrectomy irrespective of the etiology. Scintigraphic evaluation included both dynamic studies after a bolus administration of Tc-99m pertechnetate and serial renogram collections after the intravenous administration of I-131 Hippuran.