Renal-artery aneurysms (RAA), rare vascular lesions (≈0.1 % prevalence), may be detected during living-donor evaluations. We report a successful right kidney transplant from a 33-year-old woman with an 11 × 13 mm saccular RAA at the first bifurcation, detected by CT angiography. Following hand-assisted laparoscopic nephrectomy, ex vivo repair involved aneurysm excision and reconstruction with a 6-mm heparin-bonded ePTFE graft. Cold ischemia was 110 min; implantation into the 69-year-old recipient was uneventful. Immediate postoperative diuresis occurred; discharge creatinine was 1.2 mg/dL. At 18 months, both remain asymptomatic with stable renal function and normotension.

Renal-artery aneurysm

Living-donor kidney transplantation

Ex vivo vascular reconstruction

ePTFE graft

© 2025 The Authors. Published by Elsevier Inc.