Inferior epigastric artery cuff interposition for short renal artery in living-donor kidney transplantation: A case report and review of literature

Figure 1  Pre-operative computed tomography 3D reconstruction of the donor showing an early bifurcation of the left renal artery (orange arrow).

Figure 2  The donor’s left short renal artery transected at the level of its bifurcation, exhibiting a gun-barrel-like bifurcation.

Figure 3  Illustration of inferior epigastric artery harvest through the same para-rectal incision.

Figure 4 The recipient’s inferior epigastric artery was carefully dissected, opened longitudinally, and molded over a syringe to preserve its cylindric shape, thereby creating a vascular cuff for extension and anastomosis with the donor’s renal artery. A: Longitudinal incision of the epigastric artery; B: Molding of the epigastric artery transversally over the syringe; C: Creation of the vascular cuff using a continuous suture.

Figure 5  Illustration demonstrating end-to-end anastomosis between the inferior epigastric arterial cuff and the donor’s renal artery.

Figure 6 Illustration and peri-operative images of the final configuration of the renal transplant in the right iliac fossa. End-to-side anastomosis of the donor renal vein to the recipient’s external iliac vein, and of the donor renal artery via the reconstructed cuff- to the external iliac artery was performed.