When a nephrectomy is performed within a short time after transplantation, the incision can be reopened and the kidney removed. In cases where the allograft has been in place for a prolonged time, the allograft can be removed in an open way or laparoscopically. Open approach entails: subcapsular dissection and mobilization of the allograft, clamping and subsequent transection of the hilar structures, removal of the allograft, oversewing of the hilar structures, closure of the abdominal wall muscles, fascia, and skin and optional placement of a drain. Tissue from the allograft vessels should be left in place to prevent a potential rejection that could lead to pseudoaneurysms or ruptures.