Shortening a Carrel Patch in a Graft With Multiple Arteries: A Step-By-Step Technical Analysis0

Objectives: Multiple renal arteries in donor kidneys are not a rare entity. Whenever encountered, they pose a surgical challenge in renal transplant because they require a more complicated back table vascular reconstruction and implant technique. We devel-oped a unique step-by-step in vivo illustration of the application of shortening a Carrel (aortic) patch to address multiple arteries in deceased-donor renal transplant. Materials and Methods: Case report. Results: We present the case of a 63-year-old man who received a left kidney from a deceased donor with 2 arteries on a Carrel patch that were anastomosed in a neopatch model. Conclusions: A donor kidney with multiple arteries is a challenge before arterial anastomosis. Various anastomotic patterns have been described for this situation. Treatment of multiple arteries depends mainly on the donor source (living or deceased), the characteristics of multiple arteries, and the transplant surgeon's preference. When the length of the aortic patch of a deceased donor is > 2.5 cm, the surgeon may shorten it and form a neopatch to facilitate a single arterial anastomosis to the recipient.