Stone JP, et al. - In order to characterize the inflammatory contribution of the donor kidney upon reperfusion, a secondary, high-volume preservation flush following cold storage, was conducted. This study revealed a significant immune load in the donor kidney, that rapidly mobilized the following reperfusion. Via diversion of donor leucocytes and inflammatory mediators from entry into the recipient circulation, performing a secondary preservation flush prior to implantation seemed to reduce this inflammatory burden. Furthermore, it could modulate direct presentation and reduce the inflammatory contribution of the donor kidney following transplantation.