Vein cuff interposition for short renal vein in living-donor kidney transplantation: Three case reports and review of literature

BACKGROUND: With the increasing use of laparoscopic techniques in living-donor kidney transplantation, limitations in donor vessel length, particularly of the right renal vein, pose significant challenges for vascular anastomosis to the recipient's external iliac vein. These anatomical constraints can complicate graft implantation and increase the risk of postoperative complications. CASE SUMMARY: To address the issue of short right renal veins, several surgical strategies have been proposed. In this report, we describe our experience with three cases in which venous extension was successfully achieved using a venous cuff interposition technique during back-table reconstruction. This approach was used to facilitate secure vascular anastomosis and improve graft positioning in anatomically complex transplant scenarios. CONCLUSION: Venous cuff interposition represents an effective technique for managing short renal veins in living-donor kidney transplantation. It provides additional length and flexibility, easing anastomotic tension and supporting successful transplantation.