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  • 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.

FIGURE 112-52

In instances of deceased donors, we leave a circular patch of donor IVC attached to the renal vein. Since the right renal vein is usually very thin and friable, this IVC patch provides a better and safer tissue for the construction of the anastomosis with the recipient iliac vein.

FIGURE 112-53

The external iliac artery and vein are mobilized.

FIGURE 112-54

The external iliac vessels are transposed, bringing the external iliac vein lateral with respect to the external iliac artery.

FIGURE 112-55

View of the implanted kidney

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