Abdominal normothermic regional perfusion (A-NRP) has emerged as an effective strategy to improve organ quality and utilization in donation after circulatory death (DCD). By establishing a closed extracorporeal membrane oxygenation (ECMO) circuit following death declaration, A-NRP restores in situ oxygenated blood flow to the abdominal organs while maintaining isolation from the thoracic circulation. This chapter reviews the technical principles of A-NRP, with particular emphasis on challenges encountered during combined A-NRP and super-rapid recovery (SRR) of the heart and/or lungs. Key considerations include maintenance of a closed ECMO circuit, prevention of admixture between thoracic preservation solutions and the A-NRP circulation, strategies for suprahepatic inferior vena cava isolation, and coordination between abdominal and thoracic recovery teams. Practical recommendations are provided to facilitate safe, efficient implementation of A-NRP in complex multiorgan DCD recoveries and to optimize abdominal organ outcomes.