This 34-year-old white male with end-stage chronic glomerulonephritis had been receiving hemodialysis three times per week for 4 months when he was admitted to the hospital for received a living related-donor transplantation from his mother. Other than the kidney disease, the patient was in good health. The transplant was performed successfully with no complications. However, eight days later, transplant rejection necessitated returning the patient to the operating room for a nephrectomy removal of the transplanted kidney. After the nephrectomy, the patient did quite well, and was returned to hemodialysis, . The rejected kidney was edematous and the pale tan-brown cortex was discharged home in good conditionirregularly red-mottled. Upon sectioning the corticomedullary junction was not well-demarcated. The renal papillae were edematous and the renal pelvis had generalized petechial hemorrhages which extended through the 7-cm segment of ureter to a diffusely hemorrhagic terminal portion.