Dear Dr. Grief,
My son, age 35, was scheduled for a renal transplant today with a living donor; my son has PKD. The surgery was postponed, because the surgeon discovered that the veins to the donor's kidney are very short, requiring that my son's iliac system be lifted to perform the transplant. My son is overweight and the surgeon said that he needs to loose 20 lbs to make this transplant possible. He also needs the assistance of another surgeon to do this, who isn't available today. To compound the situation even more, the nation-wide and local shortage of blood is a concern. So the stars weren't aligned well for my son today.

My question is this: even under ideal circumstances (i.e., his weight was normal), how much more dangerous is such surgery than compared to using a donor kidney having adequate length veins? I know from my own transplant experience (I was transplanted at age 55 under ideal circumstance), recovery is relatively long and any pressure on the midsection causes great distress. Additional body fat must not only lengthen the recovery period, but endanger the transplanted kidney. I know there are probably many other factors to consider, but I'm wondering if we should possibly consider another donor or cadaver kidney, if available, with adequate length veins.

The surgeon is a vascular specialist and has expressed, optimistically and enthusiastically, that he can perform a successful surgery. We'll certainly try to talk to him about this, too, but would like to have some preliminary info and/or professional opinions beforehand.

Thanks for your time:)
Marc D