After dissection and cannulation of aorta and vena cava, the kidneys are washed out "in situ" with a cooling perfusion, avoiding any possibility of so-called warm ischaemia. The kidneys and their vessels, still attached to aorta and vena cava, are then en bloc removed, which enables a satisfactory preparation of the vessels for subsequent anastomosis to be performed. After an experimental study [6], four kidneys were removed according to this procedure, and transplanted after an average cold-storage time of 23 hours. Diuresis recovery was immediate, and normalization of serum creatinin, and of urinary sodium and potassium levels, was achieved within 6 days.
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