McKay and Steinberg (2010) describe that an examination of the kidney through a light microscope demonstrates swollen vascular endothelial cells whereas neutrophils are seen to migrate into the capillaries of the glomerular as well as those of the interstitium. Following the migration of neutrophils is the formation of fibrin thrombi in the capillaries of the glomerular and in the arterioles thereafter.
The renal parenchyma then dies off due to the process of ischemic hemorrhage and infarction which is usually widespread. A C4d immunolabeling test shows the peritubular capillaries to be positive due to diffusion of the C4 to the necrotic site. Immunoglobulin M (IgM) can be found when the rejection involves ABO incompatibility. In hyperacute rejection, the chances of the allograft working are very minimal as reported by Fogo et al (2006).
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