Vascular Reconstruction in Kidney Transplantation

Kidney transplantation has become the preferred mode of treatment for patient with end stage renal disease (ESRD) after incorporating into clinical practice in the 1960s. With the rising increase in ERSD worldwide and higher life expectancy, the need for kidney transplants is rising and the gap between deceased donors and patients on the waiting list is becoming wider. Living donors are subjected to less than appreciated risk of morbidity and mortality and have to be considered carefully. It is of utmost importance to utilize the available donor organs efficiently in deceased and living donors. One of the limitations has been the complex vascular anatomy of the donor. Challenging vessels in the recipients are becoming more common with previous surgeries in the Iliac vessels and open/endovascular interventions for occlusive or aneurysmal disease. This review addresses the techniques of utilizing less than ideal donor and recipient anatomy to perform vascular reconstruction.