One of the most discussed issues in abdominal aortic surgery in kidney-transplanted patients is represented by organ protection during aortic cross-clamping. We report the case of a kidney-transplanted woman who underwent surgical correction for an abdominal aortic aneurysm after she refused any endovascular approach. To maintain kidney perfusion, during surgical aortic reconstruction, a biopump was chosen. Nowadays, abdominal aortic aneurysm endovascular repair, when feasible, allows avoiding cross-clamping-related renal ischemia, although a potential risk for contrast-induced nephrotoxicity still exists. When open surgical repair is chosen, several different techniques to protect the transplanted organ have been proposed, with different potential advantages and results. In the case we reported, the use of biopump allowed an effective protection from ischemia, minimizing perioperative stress and complications.
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