Step 7 Transection of the Ureter

Before initiating final delivery of the kidney, the surgical team must be alerted that the transplantation team is prepared to receive the allograft.

The back table must be equipped with ice slush and an intracellular electrolyte preservation solution. When the recipient surgical team is ready, the ureter and its well-preserved periureteral tissue packet is transected distally at the level of the iliac vessels using an endoscopic vascular stapling device. Alternatively, hemoclips can be placed distally and the ureter divided with endoscopic shears.

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