Renofemoral shunt for protection of abdominal allografts during emergency abdominal aortic surgery

Emergency aortic surgery can be a daunting task in patients with functioning kidney and pancreas allografts because it poses the risk of allograft loss due to prolonged warm ischemia created by aortic cross-clamping. We present a case in which dual allografts, both originating from the right iliac arterial system, were protected from warm ischemia during aortic cross-clamping by creation of a temporary renofemoral shunt between the native left renal artery and right femoral artery. This simple technique maintained pulsatile allograft perfusion during aortic reconstruction for treatment of a ruptured mycotic aortic aneurysm complicated by an aortocolonic fistula.