Of the various organs which have been transplanted in experimental studies it is probably true to say that only the kidney has been widely accepted into surgical practice. For this reason the present discussion will be limited to the field of renal transplantation. The surgeon's requirement for preservation of human kidneys taken from cadaveric donors is a portable system which will afford immediate life sustaining function of the transplanted organ, and will allow time for tissue typing to be carried out, and for the recipient to be prepared. This requirement has not yet been met in full.
The effect of deprivation of blood supply (ischaemia) on renal tissue at body temperature is relevant to renal preservation when the organ is to be removed from a recently deceased donor. Wickham 1 has shown in the rabbit that 10 minutes of ischaemia leads to a transient detectable impairment of renal function. Increasing periods of ischaemia produce more severe damage until at 1 hour only 20% of normal function remains. Recovery to normality after this degree of damage may take 10 to 14 days and is not always complete. Beyond 60 minutes of ischaemia depression of renal function is severe and recovery, if it occurs, is far from complete.