Hypothermic kidney perfusion followed by normothermic reperfusion

First, the pig is sedated. After intubation and general anaesthesia, a midline laparotomy is performed and the kidney is freed from the surrounding tissue. Then the renal artery and vein are ligated and the kidney is removed. On the back-table, the kidney is placed on melting ice and the renal artery is canulated with an armoured vascular cannula. The ureter is also cannulated with a small tube. Then the kidney is flushed with a cold preservation solution via the renal artery at a hydrostatic pressure of 100 cm H2O to rinse out any blood. In the meantime the hypothermic perfusion circuit has been primed with the perfusion solution and cooled to 10°C. The kidney is mounted on the circuit by connecting the arterial cannula with the inflow cannula of the circuit. The tube in the ureter is placed inside the receptacle. Then the arterial inflow cannula is opened and the kidney is hypothermically perfused. After the desired preservation period has ended, the perfusion is stopped. The renal cannula is clamped and the kidney is removed from the circuit. It is again placed on melting ice and flushed with a cold rinsing solution. In the meantime the normothermic perfusion circuit has been primed with whole bloodand heated to 38°C. The kidney is mounted on the circuit by connecting the arterial cannula with the inflow cannula of the circuit. The ureteral cannula is connected to a collection bag allowing urinary drainage. Then the arterial inflow cannula is opened and the kidney is perfused. This is noticeable by pinking up of the kidney once reperfusion is established.