<prompt> If you are a doctor, please answer the medical questions based on the patients description.Dear Dr. Grief,My son, age 35, was scheduled for a renal transplant today with a living donor; my son has PKD. The surgery was postponed, because the surgeon discovered that the veins to the donors kidney are very short, requiring that my sons iliac system be lifted to perform the transplant. My son is overweight and the surgeon said that he needs to loose 20 lbs to make this transplant possible. He also needs the assistance of another surgeon to do this, who isnt available today. To compound the situation even more, the nation-wide and local shortage of blood is a concern. So the stars werent aligned well for my son today. My question is this: even under ideal circumstances i.e., his weight was normal, how much more dangerous is such surgery than compared to using a donor kidney having adequate length veins? I know from my own transplant experience I was transplanted at age 55 under ideal circumstance, recovery is relatively long and any pressure on the midsection causes great distress. Additional body fat must not only lengthen the recovery period, but endanger the transplanted kidney. I know there are probably many other factors to consider, but Im wondering if we should possibly consider another donor or cadaver kidney, if available, with adequate length veins. The surgeon is a vascular specialist and has expressed, optimistically and enthusiastically, that he can perform a successful surgery. Well certainly try to talk to him about this, too, but would like to have some preliminary info andor professional opinions beforehand. Thanks for your time:Marc D  <response>: Hi, If the donor vein length is low, the transplanted kidney will be under tension and there will be angulation in the veins also. It will compromise already weakened kidneys and chances for rejection will be extremely high in such situations. So it is better to find out a donor with adequate vein length rather than compromising the entire surgery. Wishing you good health. Hope I have answered your query. Let me know if I can assist you further. 