Gonadal vein reconstruction for extension of the renal vein in living renal transplantation: two case reports.

BACKGROUND: When the left kidney is harvested for living donor transplantation (LDKT), the short length of the left renal vein may eventually created a technical problem for reimplantation of the graft. We report an original technique, using the donor gonadal vein to extend the left renal vein and facilitate graft implantation. CASE REPORT: In the first case, the native graft gonadal vein was successfully used to extent a short renal vein after laparoscopic donor nephrectomy. The graft gonadal vein was utilized for the creation of graft venous return in the second case. Good graft function was observed in both cases. DISCUSSION: This original technique could lead to a functionally acceptable anastomosis without use of supplementary donor or recipient vascular tissue and ultimately to good organ function without increased peri- or postoperative morbidity during LDKT. A precise preoperative assessment of donor vascular anatomy is a key factor for donor safety and successful LDKT.