Transplant centers that do not have pulsatile machine perfusion capabilities are reluctant to accept kidneys from programs that do. Four human kidneys were retrieved by other centers, initially placed on pulsatile machine perfusion pumps for 13 to 28 hours, removed from the pumps, flushed with intracellular electrolyte solutions and cold-stored for 13 to 36 hours before transplantation at our institution. All recipients required dialysis during the first week after transplantation. The 1-month serum creatinine nadir was 2.2 plus or minus 1.1 mg. per dl., and all kidney grafts were functioning 3 months after transplantation. Pulsatile machine perfusion followed by ice-cold intracellular electrolyte flusing and simple cold storage can provide satisfactory renal function when the warm ischemia time is short.
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