To the Editor.—En bloc removal of cadaveric donor kidneys allows identification and preservation of multiple or aberrent renal arteries.1 Hypothermic preservation through the aorta2 minimizes the chance of cannula injury to the renal arteries (Fig 1) and allows adequate perfusion through all of the arteries. However, separation of the kidneys for transplantation may represent a problem, particularly if each kidney is to be transported to a different medical center. Anastomosis of a cuff of the aorta to a vascular prosthesis or division of the aorta obliquely between the renal arteries allows continued perfusion through the aorta or graft.2 Suture closure is time consuming and often performed under less-than-ideal circumstances.
The linear anastomosis (GIA) stapler can be used in almost all circumstances to close the aorta and separate the kidneys. After en bloc removal and flushing, the inferior vena cava is divided to separate the renal veins.
FLYE MW, FISH JC. Separation of En Bloc Cadaveric Kidneys With a Linear Anastomosis Stapler. Arch Surg. 1982;117(2):251. doi:10.1001/archsurg.1982.01380260117025