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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\u00a0mg\/dL. Gonadal vein anastomosis appears to be a feasible and safe alternative in complex transplant scenarios.<\/jats:p>","DOI":"10.1186\/s12882-025-04510-8","type":"journal-article","created":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T11:04:24Z","timestamp":1761131064000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of the gonadal vein for kidney transplantation in patients with iliac venous complications: case series"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8391-8658","authenticated-orcid":false,"given":"Sammara","family":"Azevedo Guedes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4310-8754","authenticated-orcid":false,"given":"Gabriel Brayan","family":"Guti\u00e9rrez-Peredo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9280-8884","authenticated-orcid":false,"given":"Rodrigo","family":"Mota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6583-3727","authenticated-orcid":false,"given":"Thiago","family":"Abud Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2441-9626","authenticated-orcid":false,"given":"Fernanda","family":"Pinheiro Martin Tapioca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-3983","authenticated-orcid":false,"given":"Pedro","family":"Botelho Alencar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7343-6775","authenticated-orcid":false,"given":"Milena","family":"Sampaio Barreto Machado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6451-7137","authenticated-orcid":false,"given":"Camila","family":"Rodrigues Durando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Andrade Lobo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3037-8448","authenticated-orcid":false,"given":"Ricardo Jos\u00e9","family":"Costa Mattoso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,22]]},"reference":[{"issue":"10","key":"4510_CR1","first-page":"910","volume":"74","author":"MO Valent\u00edn","year":"2021","unstructured":"Valent\u00edn MO, P\u00e9rez Blanco A, Marazuela R, Dom\u00ednguez-Gil B. 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