Use of the gonadal vein for kidney transplantation in patients with iliac venous complications: case series.

This study presents four urgent deceased-donor kidney transplants in women with vascular access failure, where the gonadal vein was used for venous anastomosis. Two patients were high immunological risk. Cold ischaemia time ranged from 13h47min to 26h20min. Ureteral anastomoses used Lich-Gregoir or uretero-ureteral techniques. Complications included wound infection, pyelonephritis, and antibody-mediated rejection; no vascular issues or reoperations occurred. Hospital stays ranged from 7 to 39 days. Renal function improved, stabilizing below 1.5 mg/dL. Gonadal vein anastomosis appears to be a feasible and safe alternative in complex transplant scenarios.