CASE 15: Iliac Vessel Transposition at the Time of Implantation of Right and Left Kidneys

For both live and deceased donors, we routinely implant right kidney grafts without performing a venous reconstruction.

As shown in the diagrams below, we transpose the external iliac vessels after mobilizing them.

This allows us to anastomose the short right renal vein onto the external iliac vein that is now lateral with respect to the external iliac artery.

The renal artery is then anastomosed onto the recipient transposed external iliac artery, that is easily approachable.

We also routinely perform a transposition of the iliac vessels for the implantation of left kidneys, since this arrangement prevents the crossing over of the renal vein with respect to the iliac vein and a better visualization of the iliac artery at the time of anastomosis with the renal artery.