Radionuclide scans and needle biopsies in the diagnosis and treatment of renal allograft pyelonephritis and rejection developing in the course of postoperative acute tubular necrosis

Acute renal failure immediately after operation is a common and often difficult complication of transplantation. The present report describes a recipient of a cadaver donor kidney transplant, who developed prolonged ATN, severe transplant pyelonephritis, and an allograft rejection crisis in the course of ATN. These complications responded to treatment, and eventually resulted in long-term normal renal function in the transplant. The timely use of renal scans and needle biopsies of the allograft was essential as a guide to management and to the eventual successful outcome in this case.