Orthotopic Kidney Transplant in a Patient with Augmented Bladder and Diseased Iliac Vessels: A Surgical Challenge With Successful Outcome.

Kidney transplantation offers superior outcomes compared with dialysis but requires alternative approaches in complex cases. We present a 24-year-old male patient with end-stage renal disease, neurogenic bladder, and iliac vessel thrombosis who underwent orthotopic kidney transplant with concurrent native nephrectomy.Despite challenges, including postoperative double J stent migration requiring reexploration, the patient achieved stable graft function at 14-month follow-up. This case highlights the feasibility of orthotopic transplant in high-risk patients when performed at experienced centers. Successful outcomes depend on meticulous surgical technique and multidisciplinary management.