A 31–year-old woman, with a past medical history significant for hypertension, uterine fibroids, chronic anemia, obesity, and end stage renal disease secondary to IgA nephropathy, presented to our medical center for living donor renal transplantation. The patient's 35-year-old sister was the proposed donor. The patient underwent peritoneal dialysis for 2 years, with urine production of 500 mL daily before the transplant. As part of her pretransplant workup, she had laboratory studies that revealed creatinine 16.7 mg/dL, blood urea nitrogen (BUN) 34 mg/dL, hemoglobin level 9.8 gm/dL, and a platelet count of 272 k/uL. Preoperative crossmatch of the recipient's living-related donor showed a one haplotype + match with the donor and 0% panel-reactive antibody. She was scheduled for transplant without any concerns or issues.