*Purpose: Ex-vivo normothermic perfusion (NMP) has been developed with the goal of improving viability of the thousands of donated organs that are declined for transplant every year; however, there remains a need for diagnostic tools that provide better pre-transplant analysis of such organs.

*Methods: Here, we demonstrate a computed tomography (CT)-based method of pre-transplant organ analysis named Ex-vivo Cold Infusion Scanning (EXCIS). The EXCIS protocol was developed using porcine kidneys (N=30) and transplant-declined human kidneys (N=11). During EXCIS, three sequential helical scans (scans 1-3) are obtained immediately following initiation of contrast infusion. Frangi filter-based algorithm was used to enhance and segment the organ vasculature. The vasculature radius distribution was estimated across each porcine and human organ. Furthermore, rates of contrast infusion across organs were calculated. EXCIS results for a pig kidney subject to cold storage was compared to the EXCIS of the animal’s second kidney that was subject to ischemia reperfusion injury. For two human kidneys, EXCIS was performed before and after NMP.

*Results: The porcine model of reperfusion injury demonstrated significant reduction in detected vascular radius compared to the paired cold-storage kidney (fig.1). Similar pattern of reduction in vascular radius was observed in human kidney 2 after undergoing NMP (fig.2D-E). human kidney 1 did not show decrease in radii. Furthermore, both kidneys did not display a significant change in rate of contrast uptake after NMP (fig.2A-C).

*Conclusions: EXCIS can provide a qualitative understanding of an organ’s anatomic features and deliver quantitative information about vascular radius and perfusion pre-transplant. Furthermore, EXCIS has the potential to demonstrate the severity of ischemia reperfusion injury during NMP, allowing us to better understand and utilize this platform in the future.

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