*Purpose: The possibility to diagnosis abdominal aortic aneurysm (AAA) in patients who underwent kidney transplantation (KT) is increasing. Immunosuppressive agents may effect on AAA progression. When repairing of AAA for the KT recipients, it need to be consideration of preserving the internal/external iliac arteries and renal function without ischemic injury to the transplanted kidney. Endovascular aortic aneurysm repair (EVAR) can be a good choice of treatment regarding both points as avoiding aortic cross clamping. And EVAR does not need other methods to provide renal perfusion including bypasses. We herein present our experience performing EVAR in kidney transplanted patients

*Methods: We performed EVAR in 3 KT recipients from 2017 to July 2018. The patients’ records were retrospectively reviewed. All of three patients diagnosed with infra-renal AAA not accompanied with iliac artery aneurysm. All patients were treated with bifurcated endovascular devices

*Results: A 61 years old man who underwent KT from deceased donor two years ago. He performed EVAR cause of rapidly growing AAA sized from 3.8cm to 6.5cm. He got cardiac problem and decreased renal function after treatment of acute rejection. So he needed less aggressive procedure. A 50 years old man got the first KT before 30 years ago. He was preparing for the second KT from a living related donor, He found newly developed 6.7 cm sized AAA. He need to preserve of Lt. iliac arteries. 1 month After performing EVAR, he underwent the second KT successfully. A 53 years old man, He underwent KT 28 years ago. He visited ER due to abdominal pain. He found 5.5cm sized AAA on CT. His graft renal artery was connected to right internal iliac artery with end to end anastomosis. His creatine level was 1.83 mg/dL. To protect renal function, CO2 angiography was used to minimize the amount of contrast. Dye was only used 5cc. AFX II (Endologix) stent graft was deployed. His renal artery was preserved. But there was type Ib endoleak on the Rt. side limb. Post op creatine level was 1.95 mg/dL

*Conclusions: EVAR in patients with a kidney transplantation is a feasible option without impairing renal arterial flow. And for patients waiting for kidney transplantation, EVAR is the preferred method to preserve the internal/external iliac arteries to allow a future anastomosis between renal artery of graft and recipient’s iliac artery.

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