目的　探讨糖尿病肾病合并髂动脉严重硬化患者的肾移植手术技巧。　方法　 15例糖尿病肾病合并髂动脉严重硬化的肾移植患者 ,8例次清除髂内动脉内膜硬化斑块后 ,由钛轮钉端端吻合动脉 ;10例次剥离髂总或髂外动脉硬化内膜 ,与肾动脉端侧吻合。　结果　术后心跳骤停死亡 1例 ;1例病人连续 3次发生移植肾血流灌注不足导致的移植肾原发性无功能 ,第 4次肾移植肾功能良好 ;其余13例病人首次移植术后肾功能良好。　结论　严重动脉硬化患者的动脉吻合困难 ,为保证移植肾有足够的血流灌注 ,应根据病人的不同情况选择吻合血管 ,并行硬化内膜切除术 Objective To investigate the surgical techniques of kidney transplantation in diabetic nephropathy patients with severe sclerosis of iliac artery. Methods Fifteen patients with diabetic nephropathy with severe sclerosis of iliac artery were involved in this study. Eight patients underwent endoscopic anastomosis of the internal iliac artery after eradication of the atherosclerotic plaque of the internal iliac artery. Ten patients underwent dissection of common iliac or external iliac arteriosclerosis Membrane, and renal artery anastomosis. Results One patient died of postoperative cardiac arrest. One patient developed primary renal transplantation due to inadequate perfusion of transplanted kidneys, and the fourth renal transplant showed good renal function. The other 13 patients underwent primary renal transplantation Kidney function is good. Conclusion Severe arteriosclerosis in patients with arterial anastomosis difficulties, in order to ensure adequate graft perfusion, should be selected according to the patient’s situation of vascular anastomosis, concurrent sclerectomy