PMC9225888_01
Aorta and damaged renal artery at the level of its takeoff.
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fig1
During the kidney retrieval, the aorta and inferior vena cava (IVC) were divided cranially at the level of the takeoffs of both renal arteries and veins with damage to the takeoff of the right renal artery at its ostium (Figure 1).
Reconstruction of the aorta and ostium of the right renal artery with the aortic patch from the same donor.
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fig2
Since a direct closure of the proximal aorta vascular end would compromise the lumen of the damaged right renal artery and the opening of the left renal artery, same donor's aortic patch was used to repair the proximal end of the aorta without compromising the right and left renal arteries with 7-0 Prolene  running sutures (Figure 2).
EBPK allograft placed in situ after transplantation. The vascular anastomoses between the aorta and IVC and recipient external iliac vessels have been finished. EBPK: en bloc pediatric kidneys; IVC: inferior vena cava.
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fig3
Once placed on the RPM, the flow and resistance improved from 12 mL/min and 0.41 mmHg/mL/min to 66 mL/min and 0.27 mmHg/mL/min.  Figure 3 shows the EBPK allograft placed in situ after transplantation.
PMC9225888_02