*Purpose: A single, large organ procurement organization (OPO) sought to document the use of extra-renal ex vivo pumping in the management of the deceased donor organs allocated and recovered from donors in its local donor service area (DSA).

*Methods: The outcome of extra-renal organs procured with the intent to transplant from a single OPO from 1/1/19 – 12/5/19 were analyzed. Utilization of a pump was only supported by the OPO when authorization for research had been obtained in addition to donation/transplantation, Those organs entered into ex vivo pump protocols were identified and outcomes tracked.

*Results: A total of 317 deceased donors were taken to the OR with the intent 1 or more organs. Of these, 8 donors (all were brain dead vs. DCD) had extra-renal organs recovered with the intent to transplant after placement on an ex vivo pump. 13 organs were pumped; 10 lungs, 1 heart, 2 livers. 100% of these organs were transplanted. 100% functioned immediately.

*Conclusions: Kidney treatment with hypothermic, pulsatile perfusion pumps is common and within the standard of care. Multiple pumps are currently under development and study in the United States for the treatment and assessment of other marginal deceased donor organs. UNOS policy does not address how or whether organ allocation should accomodate the associated protocols/trials. This OPO has supported and participated in the use of ex vivo pumping when authorization for research had been obtained, when the procurement schedule would not be altered, and as long as the allocation sequence was not altered from UNOS policy. Responsible stewardship demands that organ discard not result from inappropriate use of research pumps. The universal completion of transplantation and universal early function of 100% of these 13 organs suggests this is not happening. Ongoing study of these support devices should continue in the same context.

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