KIDNEY - Rejection

A kidney showing numerous irregular cracks on the outer surface, with a haematoma in the capsular region towards one pole; the cortico-medullary division is blurred over much of the specimen, and at the lower pole there is a small infarct.
This young man presented with a nephrotic syndrome secondary to focal glomerulosclerosis. After 3 years, he developed renal failure, and an AV fistula was created in his left arm for home dialysis. He was selected for transplant, but the transplanted kidney, seen here, was rejected after approximately 3 weeks. The cracks in the cortex appeared during fixation after the rejected kidney had been removed.