- Placed in the iliac fossa in the experitoneal position
- Leaving the native kidneys in-situ
- Vascular
- Donor Renal Vein is anastomosed end-to-side to the External Iliac Vein
- If from deceased donor, Renal Artery will come with Carrel Patch
- Patch of Aorta that gives rise to Renal Artery/arteries
- Anastomosed end-to-side to the External Iliac Artery
- If the donor renal artery lacks an aortic patch, (living donor transplant)
- Anastomose the donor artery end-to-end to the recipient Internal Iliac Artery
- Following completion of the venous and arterial anastomoses, the vascular clamps are removed and the kidney is allowed to reperfuse with blood
- Ureter
- Kept reasonably short to avoid the risk of distal ischaemia
- Direct implantation of the ureter into the dome of the bladder
- Mucosa-to-mucosa anastomosis
- Followed by closure of the muscular wall of the bladder over the ureter to create a short tunnel
- JJ ureteric stent left in-situ
- Reduce the risk of urine leak or early obstruction
- Before closing, important to check is in satisfactory position
- Without kinking/torsion
