Techniques – Orthotopic kidney transplantation in patients with diseased inferior vena cavas

Heterotopic renal transplantation is the treatment of choice for patients with end-stage renal disease (ESRD). ESRD may be associated with inferior vena cava (IVC) thrombosis as a consequence of femoral dialysis catheter placement, IVC filter or stent, or hypercoagulable states,1 precluding renal transplantation into the iliac fossa. In such patients, orthotopic kidney transplantation (OKT) has been described with acceptable rates of complications and reasonable long-term graft outcomes.2–