Reconfigured Saphenous Vein Interposition as a Salvage Technique for Right Renal Allograft Vein Tear

In living donor renal transplants, the right kidney is less favored. The shorter length and thinner wall of the right renal vein presents technical challenges. Herein, we describe a method of utilizing reconfigured saphenous vein as an interposition graft to extend the graft renal vein. In this case, a 46-year-old male underwent renal transplantation, and postdeclamping, significant bleeding from a small venous twig was encountered. Attempted clipping resulted in a tear, necessitating suture repair, which compromised the lumen. The kidney had to be explanted due to congestion. A segment of the saphenous vein was harvested, detubularized, and reconfigured along the horizontal axis with 7-0 prolene suture. The graft kidney was then reanastomosed as before, and the transplant was completed successfully.