 Coagulation is activated in the renal transplant during reperfusion, when circulating factor VIIa FVIIa comes into contact with the tissue factor TF, which is expressed on the endothelium due to ischaemia. FVII-TF complex activates factor X FX and activated FX FXa cleaves thrombin FII from prothrombin. Thrombin activates thrombocytes, cleaves fibrin from fibrinogen and activates factor XIII FXIII, which stabilizes fibrin clot. Fibrin has been demonstrated to accumulate in the kidney graft during reperfusion. Fibrin accumulation is aggravated by inhibition of fibrinolysis due to reperfusion. 