The paper shows how to create the best ways extracorporeal reconstruction of the renal veins in related transplantation. It is necessary to consider the possibility of autoplasty at nephrectomy from a living donor, expansion of the distal renal vein and allow its implementation through the walls of the gonad donor veins. When there are several veins, the largest is used for anastomosis, others may be tied because of a well-developed network of intrarenal collateral venous outflow. With the right approach to the choice of method of angioplasty and its skillful implementation, taking into account the structural features of the vascular bed of the donor, the presence of several vessels supplying the kidney of a living related donor, not a contraindication to of transplantation and does not reduce the quality of the transplanted organ.