Two patients had ruptures of homografted kidneys; in one the kidney had to be removed; in the other the bleeding was so severe that the patient died within minutes. The clinical picture is described, a hypothesis of the mechanism of the rupture is discussed, and an outline of the treatment is given. The incidence of rejection in all histologically examined ruptured kidneys and the plausible mechanism of rupturing during rejection has led us to the conclusion that a rupture of a homografted kidney is not a spontaneous event, but a complication of rejection.
Kootstra G, Meijer S, Elema JD. "Spontaneous" Rupture of Homografted Kidneys. Arch Surg. 1974;108(1):107-112. doi:10.1001/archsurg.1974.01350250093025