RT Book, Section A1 Bijol, Vanesa A2 Molmenti, Ernesto Pompeo SR Print(0) ID 1194189441 T1 Thrombotic Microangiopathy T2 Molmenti’s Kidney and Pancreas Transplantation: Operative Techniques and Medical Management, 2e YR 2023 FD 2023 PB McGraw Hill PP New York, NY SN 9781260474275 LK accesssurgery.mhmedical.com/content.aspx?aid=1194189441 RD 2024/10/10 AB 30-year-old man with end stage kidney disease attributed to hypertensive nephrosclerosis. Received a living unrelated kidney transplant 6 months prior to current presentation. Admitted with an oral abscess and acute kidney injury in the setting of dehydration. A biopsy was obtained to address a persistently elevated creatinine despite adequate rehydration.Allograft biopsy (Figure 112-113) showed signs of thrombotic microangiopathy (image showing a thrombosed glomerulus, H&E 200x). On review, native kidney biopsy (Figure 112-114) also showed features of chronic thrombotic microangiopathy.It is likely that the current process in the allograft is a recurrent thrombotic microangiopathy. A diagnosis of hypertensive nephrosclerosis in young patients should always be interpreted with caution.