An ex vivo resuscitation of kidney function following substantial post
mortem warm ischemia was attempted with the ultimate goal of overcomi
ng the ischemic barriers in organ retrieval for transplantation. The r
esuscitation technology involved reperfusion at 32 degrees C with an a
cellular solution to reinstitute oxidative metabolism of sufficient ma
gnitude to restore function after a substantial postmortem warm ischem
ic insult. The ability to resuscitate renal function at various time p
eriods postmortem was evaluated. Resuscitation parameters included per
fusion pressures, vascular flow rates, vascular resistances, restorati
on of diuresis with concordant urinary creatinine concentrations, and
blinded histologic evaluations. The results of this study suggest that
it may one day be feasible to resuscitate organs following as much as
2 hr of postmortem warm ischemia for clinical transplantation. An exp
anded donor pool consisting of allografts resuscitated post mortem fro
m what is now considered to be the ''non retrieval donor'' could help
alleviate the chronic organ shortage. Furthermore, since organs resusc
itated ex vivo at 32 degrees C exhibited ongoing metabolism, which was
artificially supported rather than inhibited by traditional hypotherm
ia, diuresis was restored. The ability to collect and analyze urine du
ring organ resuscitation and preservation may present the opportunity
to assess organ function prospectively.