Renal transplantation improves the patient’s quality of life and increases post-transplant life expectancy; with a mortality rate of 2.0/100 patients a year among patients with living-donor transplantation, compared to a 6.3/100 patients a year mortality rate among patients receiving dialysis treatment [4,5]. For the aforementioned reason, it is of prime importance to know the vascular anatomy of the donor; altogether, with the aim to establish better pre-surgical planning.

The arterial vasculature of the normal kidney originates at the L2 level, from underneath the mesenteric superior artery, it follows an anterior trajectory to the renal pelvis before entering the renal hilum where it segments. The right renal artery (RRA) presents an oblique descent in relation to the right kidney, circumventing posterior to the Vena Cava and being slightly longer than the left renal artery (LRA). The left renal artery originates just underneath de RRA and presents a descending trajectory anterior in relation to the left kidney [6].

The normal venous kidney vasculature presents an anterior trajectory in relation to the renal arteries at the renal hilum level and is formed by the confluence of multiple renal vessels [6]. The right renal vein (RRV) has a mean length of 2-4cm and drains its contents into the inferior Vena Cava; meanwhile, the left renal vein (LRV) has a mean length of 6-10cm and also drains its contents into the inferior Vena Cava, crossing in front of the abdominal aorta and behind the superior mesenteric artery [6].

The conventional pre-surgical protocol includes an initial bilateral renal echography, to assess the renal morphology, followed by a digital subtraction angiography in order to identify the renal arteries and its normal or pathological variants [2].

Digital subtraction angiography is an invasive procedure employing intraarterial administration of iodine contrast agent in order to visualize the blood vessels [6-8]. The other option used in renal mapping is the computed tomography angiography; which is a minimally invasive technique, where a contrast agent is employed intravenously, allowing the assessment of the anatomic renal vasculature, as well as the assessment of atherosclerosis of the renal vessels and as regions of stenosis [9].

MR angiography is a minimally invasive technique, which depends on the selective imaging of contrast agent (Gadolinium) flow; permitting a three-dimensional reconstruction of the vessel and intraluminal image of the vessels. It has been shown that the use of MRA actually is a safe procedure for renal donors [9-13] and allows visualization of vascular abnormalities [9], as well as being a low-cost procedure [14].