Transplantation of renal allografts with multiple arteries is challenging. We describe a simple technique to facilitate multiple anastomoses. The internal iliac artery and suitable branches are dissected and then explanted from the recipient by dividing the main trunk of the vessel. Multiple renal arteries can then be anastomosed end-to-end to suitable branches of the internal iliac graft over silastic catheters, on the back table, under cold storage conditions (Fig. 1). The kidney is then implanted by re-anastomosis of the internal iliac trunk to its parent main stem. This quicker and simpler arterial anastomosis optimises perfusion, reduces anastomosis time and warm ischaemic injury.
Figure 1.
Explanted internal iliac artery graft in position prior to anastomosis to the renal allograft.