The surgical management of aortic aneurysms in kidney transplant patients is a difficult clinical scenario where preservation of the kidney allograft during aortic cross-clamping is paramount. We describe a novel technique for renal protection during abdominal aortic aneurysm repair with in situ oxygenated pump perfusion of the transplanted kidney. A percutaneous approach is used for common femoral artery and vein cannulation and a cardiopulmonary bypass circuit to provide retrograde oxygenated pump perfusion to the transplanted kidney. This technique allows adequate kidney perfusion during warm ischemia and minimizes morbidity by using a percutaneous access technique
