This case illustrates renal artery anatomical variants identified on the workup for a potential donor. The right kidney has, besides the main renal artery, a lower polar artery and an upper capsular accessory artery. The left kidney has three equal-sized renal arteries (upper, middle, and lower). These findings are relevant, as the surgeons, if considering to transplant one of these kidneys, will probably need to create separate anastomotic sites in the recipient iliac artery, thus increasing the risk of potential complications.

Following publications in this field ¹, in cases of multiple renal arteries, at our institution we use the term "renal arteries" when they are of the same size and "renal and accessory arteries" when there is one dominant and other smaller artery/arteries.

It is important to bear in mind that accessory renal arteries may also rarely arise from other arteries rather the aorta, such as the

• superior or inferior mesenteric artery
• celiac artery
• middle colic artery
• lumbar arteries
• gonadal arteries
• iliac arteries
• middle sacral arteries
• even from the contralateral renal artery ¹