13. The kidney is wrapped in a cold, moist laparotomy pad. S | Figure 1

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  1. The kidney is wrapped in a cold, moist laparotomy pad. Sutures are placed within the renal vein and artery and sewn to the iliac vein and iliac artery, respectively, in the patient. The kidney is then reperfused. Finally, the ureter is attached to the bladder, completing the living donor to recipient kidney transplant. Do the techniques involved in transplanting an organ from a living donor differ from those from a deceased donor? Do organs from living donors last longer? #muscrounds #muschealth

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Right kidney that will be prepared for #Transplantation, obtained from a cadaveric donor almost 24 hr before. Here, you can see the renal artery (Orange), part of the vena cava (blue), ureter (yellow), gonadal vein (green) and the kidney's parechima surrounded by the perirenal fat (Black). The gonadal vein was completely removed with most of the perirenal fat, all the time working over ice to keep a proper temperature.](https://app.figure1.com/case-detail/2586c0e4-bfe8-4f2b-a443-60d7971fea9a)



A 63 year old female patient with history of renal transplant and small indeterminate vascular malformation at the transplant renal hilum was referred for progressive weight loss, abdominal pain, and recurrent urinary tract infections. Multimodality evaluation revealed an enlarging and tortuous renal vein at the graft hilum demonstrating rapid filling on arterial phase followed by early inferior vena cava opacification. Findings were consistent with an enlarging arteriovenous fistula.
Figure 1. MR Angiogram (2011) shows abnormal tangle of vessels at the graft hilum. Note main renal artery off the external iliac artery, and the main renal vein draining into the external iliac vein. There is rapid early filling the veins bypassing renal parenchymal opacification. AV fistula is favored as the location is at the hilum with direct communication and absent nidus. AV malformation considered unlikely given its location and pattern of enhancement.
Figure 2. Ultrasound shows a markedly enlarging and tortuous renal vein with patent flow and no thrombus.
Figure 3. CT Angiogram shows a fistulous connection between the main renal artery and aneurysmal vein just beyond the main renal artery anastomosis.
What is the most common cause of renal arteriovenous fistula?
1- Percutaneous biopsy
2- Congenital
3- Post infection
4- Neoplasm](https://app.figure1.com/case-detail/2984bfc1-3bfe-4500-af5f-367e005c1ded)



#Kidney(s) #Diabetes-mellitus #Renal-failure #Transplantation kidney transplant](https://app.figure1.com/case-detail/36668a3f-b715-4219-b846-2743a3df5707)



Rotating in transplant surgery. These "kidney pods" as I call them are used to transport kidneys from both live and deceased donors if they're not being immediately put into the recipient. The arterial cuff (section of aorta that includes renal artery) is cannulated and the solution flows out of the vein into the little bath and circulates back. A kidney can be kept viable for 24 hours on this device! #Transplantation](https://app.figure1.com/case-detail/38029baa-ce5f-4569-8cb8-f07d7a455859)