A study of 31 uncontrolled non-heart beating donor (NHBD) kidneys put to rest the concern of poor function when using cold storage preservation for these kidneys. The median warm ischemia time (WIT) was 30 minutes (range 7-60). All cases prior to kidney recovery had in situ preservation by combined intravascular and intraperitoneal cooling (mean time =145 minutes, range 60-382). Pulsatile machine preservation (PMP) was used for all recovered from brain dead donors (BDD); mean pressure = 24.87 (sd=4.5); flow=134.03 (sd=24.17); resistance = 0.190 (sd=.05) kidneys with immediate function (IF) had lower mean resistances (0.160, sd=.04) than did kidneys with delayed function (DGF), (.200,sd=.04,p=.02).

The result showed that the IF rate was 29.03% , while the DGF rate was 64.51%.two kidneys that failed to function (6.455) were lost from renal artery thrombosis and hyperactue rejection mates to those kidneys functioned appropriately. 1 year actual graft survival (GS) for kidneys transplanted at various local centers was 89%.2-year was 78%.3; 3-year was 78%;4-year was 58% and patient survival (PS) was 93% , nothing that both kidneys were functioning normally at death. For 21 kidneys transplanted at the institution PS was 100% and GS 91%. One kidney (SCr of 1.1 mg %) was removed because of recurrent nephritic syndrome; the other kidney failed from noncompliance after three years of normal function. None of the 31 kidneys were lost from acute rejection. Renal Function of NHBD and BDD was equivalent after three months.

It was therefore heartening to note that PMP eliminated primary nonfunction from ischemic injury associated with NHBD. Kidney function recovered satisfactorily after 60 minutes WIT, six hours in situ preservation and 56 hours total preservation. PS, GS and renal function of NHBD kidneys was equivalent to those achieved with BDD kidneys. Other factors that contribute to good result are: donor age of less than 60 years; recipients of low immunologic risk: antilymphocyte therapy to be used with delayed introduction of cyclosporine/tacrolimus; ischemia and preservation times to be kept as short as possible.