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Here's a diagram of normal renal transplant

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Anatomy that's important to remember that these renal

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transplants are placed extra peritoneally within

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the iliac Foss on the pelvis and they're more often placed

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on the right side rather than the left side due

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to the ease of vascular reconstruction of

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some of the anastomoses. If you do end up seeing a left

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lower quadrenal transplant, it's often because the patient had a prior

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right, you know transplant that fails

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now the renal transplant itself can be derived from

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a donor that's deceased or donor that's living and you

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make three and ask to Moses between the

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artery the vein and as well as the ureter which

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anastomosis to the bladder.

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Now for deceased donor anastomoses, the

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renal arteries often harvested with a small oval patch

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of the donors aorta and that's

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called a Carol patch and you really are anastomosing that

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oval patch into the recipients right iliac

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artery over here.

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For a living donors, you're not going to take out a patch of

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the living donors aorta. So the renal artery is attached directly to the iliac

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artery over here.

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The vein is also attached similarly to the

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iliac arteries on the right side. And the ureter is

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attached to the bladder with oftentimes. It's tent

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being placed which has been shown to decrease the risk of urine

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leaks or your instructors in the post-operative period

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One of the important things to remember is that the renal artery and renal Vein

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from the renal allo graft is most often

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anastomos to the external iliac artery

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less often to the internal iliac arteries

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and commonliac arteries. And so when you're looking on ultrasound

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you're looking on different Imaging modalities, that's where

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you're going to be looking for the anastomoses.