Microvascular
thrombosis is an uncommon pathological finding in deceased
donor kidneys. It is associated with
disseminated intravascular coagulation (
DIC) after
brain injury in the
donor. Although
DIC in deceased
kidney donors is known to have no
association with
graft outcome, microvascular
thrombosis with
DIC in a
donor can cause renal
graft impairment. For this reason, some
transplantation centers do not accept these
kidneys. A 39-year-old
female donor had a
subarachnoid hemorrhage. After a short period of
cardiopulmonary resuscitation, we applied
extracorporeal membrane oxygenation to maintain
hemodynamic stability. The
laboratory data were consistent with
DIC. The recipient was a 38-year-old
male patient who had been undergoing
hemodialysis for 7 years because of
end-stage renal disease of unknown cause. Zero-
time graft biopsy revealed multiple intraluminal
fibrin thrombi without peritubular capillaritis.
Delayed graft function occurred after
transplantation, and
hemodialysis was started.
Graft renal
biopsy was performed on the third day after
transplantation. The percentage of intraglomerular
fibrin thrombi had decreased, and no significant peritubular capillaritis or C4d
staining was observed. The function of the transplanted
kidney started to recover, and
hemodialysis was discontinued on the 10th day after
surgery without specific
treatment. Follow-up
biopsy performed 20 days after the
transplantation revealed normal
kidney with completely resolved
fibrin thrombi. We
report herein a case of microvascular
thrombosis in renal
allograft from a
DIC donor.