Hmm... That sounds like it would be tough to do. 45 Winchester Magnum is powerful enough that it's going to need a locked action. Trying to feed a pistol-type cartridge through the AK action will be a real trick. That's not to say that it's impossible or anything, but I think it would require a single-feed magazine, possible narrowing of the feed lug on the bolt to clear the magazine feed lips, and the feed ramp would probably have to be removed from the trunnion to ensure enough clearance for reliable feeding. The mouth of the chamber will probably need a generous taper to accept the round reliably.
Double-feed magazines might work, but would have to be very carefully placed to allow for reliable feeding. Too close and the guide/locking lugs on the trunnion will deflect the front of the round too much to get to the chamber. Too far and the bullet will be free of the magazine before it begins entering the chamber. Getting a fat, stubby bullet to guide into the chamber is much trickier than guiding a long, slender bullet to do the same thing. A single-feed magazine would solve the problem of deflecting the round to the left or right during feeding, since a single-feed magazine by its very nature would have the round centered.