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The transplanted kidney is usually placed extraperitoneally in the right or left iliac fossa where it can be palpated, and provides easy access for renal biopsy.

The renal artery and vein of the donor kidney are anastomosed respectively, to the recipient's internal iliac and external iliac artery and vein. The donor ureter is implanted into the bladder through a submucosal tunnel.

The recipient's own kidneys are left alone unless there are reasons for nephrectomy, for example:

  • grossly dilated or refluxing ureters liable to cause urinary infection
  • polycystic kidneys that are large or infected
  • persistent hypertension

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