Successful Elongation of a Short Graft Renal Artery by a Gonadal Vein

The objective of this presentation is to share our experiences with a successful reconstruction of a short graft renal artery using a gonadal vein, which occurred during a difficult laparoscopic donor nephrectomy.

A 27-year-old man was referred to our clinic for a living-related renal transplant with a diagnosis of end-stage renal disease. The donor was with his mother. At last, a laparoscopic donor nephrectomy was planned. Massive intra-abdominal hemorrhage occurred during the dissection of renal artery. Urgent intervention was performed to maintain the patency of renal allograft and to stabilize the donor. Hemorrhage was brought under control. Donor nephrectomy was completed with a short remaining segment of renal artery. We decided to use the elongation of the graft renal artery using the gonadal vein of the same side was decided. End-to-end anastomosis was performed. After elongation of graft renal artery, anastomosis to internal iliac artery was performed. The trans-plant procedure was completed successfully. The kidney functioned immediately. Doppler ultrasound revealed that perfusion of the kidney was normal. The postoperative creatinine levels of recipient were in the normal ranges. Daily urine output was normal. There are not enough publications about elongation of graft renal artery using gonadal vein.

Elongation of a short remaining graft renal artery by using gonadal vein seems to be a simple, safe, and reliable method. This technique provides an alternative approach for the reconstruction of short renal arteries in living-donor kidney transplants.