Lekehal B, Ait Youssef N, Lekehal M, Bakkali T, Jdar A, Bounssir A. Vein cuff interposition for short renal vein in living-donor kidney transplantation: Three case reports and review of literature. World J Transplant 2026; 16(1): 110683 [DOI: 10.5500/wjt.v16.i1.110683]
Corresponding Author of This Article
Noura Ait Youssef, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat Mohammed V University in Rabat, Avenue Bettouga, Rabat 6527, Rabat-Salé-Kénitra, Morocco. nouraaityoussef94@gmail.com
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Transplantation
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 18, 2026 (publication date) through Jan 14, 2026
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World Journal of Transplantation
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2220-3230
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Lekehal B, Ait Youssef N, Lekehal M, Bakkali T, Jdar A, Bounssir A. Vein cuff interposition for short renal vein in living-donor kidney transplantation: Three case reports and review of literature. World J Transplant 2026; 16(1): 110683 [DOI: 10.5500/wjt.v16.i1.110683]
World J Transplant. Mar 18, 2026; 16(1): 110683 Published online Mar 18, 2026. doi: 10.5500/wjt.v16.i1.110683
Vein cuff interposition for short renal vein in living-donor kidney transplantation: Three case reports and review of literature
Brahim Lekehal, Noura Ait Youssef, Mehdi Lekehal, Tarik Bakkali, Asma Jdar, Ayoub Bounssir
Brahim Lekehal, Noura Ait Youssef, Asma Jdar, Ayoub Bounssir, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat Mohammed V University in Rabat, Rabat 6527, Rabat-Salé-Kénitra, Morocco
Mehdi Lekehal, Department of Vascular Surgery, Centre Hospitalier Universitaire IBN SINA, Rabat 6527, Rabat-Salé-Kénitra, Morocco
Tarik Bakkali, Department of Vascular Surgery, Mohammed V University, Rabat 6527, Rabat-Salé-Kénitra, Morocco
Author contributions: Lekehal B carried out the experiments and led the project administration; Ait Youssef N and Lekehal M wrote the first draft of the manuscript and collected the data; Bakkali T, Jdar A, and Bounssir A contributed to the data interpretation and visualization. All authors reviewed, edited, and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Noura Ait Youssef, Department of Vascular Surgery, Faculty of Medicine and Pharmacy of Rabat Mohammed V University in Rabat, Avenue Bettouga, Rabat 6527, Rabat-Salé-Kénitra, Morocco. nouraaityoussef94@gmail.com
Received: July 14, 2025 Revised: August 8, 2025 Accepted: October 24, 2025 Published online: March 18, 2026 Processing time: 184 Days and 15.9 Hours
Abstract
BACKGROUND
With the increasing use of laparoscopic techniques in living-donor kidney transplantation, limitations in donor vessel length, particularly of the right renal vein, pose significant challenges for vascular anastomosis to the recipient’s external iliac vein. These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications.
CASE SUMMARY
To address the issue of short right renal veins, several surgical strategies have been proposed. In this report, we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction. This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios.
CONCLUSION
Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation. It provides additional length and flexibility, easing anastomotic tension and supporting successful transplantation.
Core Tip: In living-donor kidney transplantation, short renal veins following laparoscopic donor nephrectomy can complicate vascular anastomosis. The use of a venous cuff interposition is a practical solution that increases vein length and flexibility, reduces anastomotic tension, and facilitates a secure end-to-side anastomosis to the recipient’s external iliac vein, thereby optimizing hemodynamic stability and potentially decreasing the incidence of vascular complications.
