Renal Subcapsular Hematoma: A Rare Potentially Reversible Cause of Acute Graft Dysfunction With Immediate Intervention

Subcapsular hematoma of the kidney allograft is an often underrecognized but reversible cause of acute graft dysfunction, which occurs most commonly after percutaneous biopsy. We retrospectively reviewed 4 cases diagnosed with subcapsular hematoma between 2020 and 2023. All patients developed acute kidney injury, hypertension, and graft pain following kidney biopsy. Only 1 recovered fully after prompt surgical evacuation; delayed presentation and intervention in the others resulted in permanent graft loss. These findings emphasize the need for high index of suspicion in post-biopsy patients with acute graft dysfunction, as early diagnosis and timely intervention are essential for preserving graft function.