In spite of highly sophisticated tissue matching reducing immunogenicity of a graft a high degree of immunosuppression is mandatory to achieve good graft survival. Septic complications such as a rupture of an anastomosis threaten the recipients life. Thorough donor selection, strict asepsis, as well as repeated bacteriologic examination gives the chance to decrease morbidity and mortality of kidney grafting. In the retrospective analysis of 135 kidney transplantations septic vascular complications occurred in 3.7%. The surgical procedure of choice after graft removal is the ligation of the external iliac artery. Only in one out of four cases ischemia of the lower extremity had to be treated by an extra-anatomic femoro-femoral bypass.
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