[Orthotopic kidney transplant (OKT): An alternative when heterotopic transplant is not feasible.]

OBJECTIVE Kidney transplant is the treatmentof election of end-stage chronic renal disease, usually being heterotopic extraperitoneal in the iliac fossae, with successful results. This technique can be challenging or even not feasible, usually in cases of severe vasculopathy or previous grafts, so urologists should consider alternatives such as orthotopic transplant. MATERIAL AND METHODS: We present three cases oforthotopic kidney transplant (OKT) made in Cruces University Hospital from 2001 to 2019, out of 2580 cases. We review recipients' medical history, indication,surgical technique and post surgical evolution. RESULTS: The average age of the patients was 51.6 years. The indication was severe vasculopathy of iliac vessels. We made left nephrectomy, followed by venous renal end-to-end anastomosis, arterial end-to-side anastomosis to aorta and pyelo-pyelic anastomosis with catheter,with immediate function of the graft. The patients' evolution was favourable, without significant complications and no differences with heterotopic transplant. CONCLUSION: OKT is a good alternative when heterotopicis not feasible, with an acceptable number of complications and similar survival.