*Purpose: Metabolic activity in cooled kidneys is minimal at 5ºC and resumes above 15ºC, a temperature reached after only 15 min of warm ischemia time (WIT); we set out to develop a novel, inexpensive device to maintain allograft temperatures ≤ 5ºC, thereby limiting ischemic damage during transplantation.

*Methods: 3/16” aluminum tubing was organized in a serpentine pattern to create a malleable, form-fitting cooling jacket. Coolant comprised 4ºC saline solution flowing at 240 mL/min. Adult porcine kidneys (n = 4) (175 g, 13x7x3 cm LxWxH) were used to test the device. Kidneys were placed at 24ºC; surface and core temperatures were monitored using implanted thermocouples. Device usability was tested by anastomosing porcine kidney vessels to GORE-TEX® vascular grafts with the cooling jacket in place in a simulated ex-vivo operative field.

*Results: Our cooling jacket costs less than $3.00 to produce and is moldable to any size kidney. The device resulted in mean surface and core temperatures at 60 min of (mean ± standard deviation (SD)) 5.8±0.6ºC and 5.4±0.5ºC respectively, significantly less than those of the control, 16.6±1.4ºC and 16.6±1.2ºC (p<0.00001 in both), respectively. Moreover, our device mitigated surface temperature increases (2.4±1.3ºC vs. 12.9±0.9ºC) and core temperature increases (2.8±1.7ºC vs. 14.1±1.5ºC) at 60 min (p<0.00001). Ex-vivo anastomosic testing was not inhibited or delayed by our device during testing by expert transplant surgeons.

*Conclusions: WIT is associated with many adverse outcomes. We developed a novel inexpensive, and easy-to-use aluminum cooling jacket that mitigated temperature increase, and maintained renal temperatures below metabolically-active levels, without impeding anastomoses.

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