“…15 Additional applications of the end-to-side technique reported in the human literature involve ipsilateral placement in double renal transplantation, successful engraftment of kidneys with multiple renal arteries, and other situations involving vascular disease or anomalies. [16][17][18][19][20][21] In contrast, reports of experimental and clinical renal transplantation in dogs describe the use of a technique similar to that described by Kuss, 10 except that the renal artery is anastomosed to the external, not the internal, iliac artery in an end-to-end fashion. 2,3,8,22 The reason for this adaptation is not clear, but it is largely accepted that the collateral circulation of the pelvic limb in dogs allows for sacrifice of the external iliac arterial axis without complication.…”