*Purpose: To reduce discard of injured kidneys with parenchymal injury or perinephric hematoma . Young donors with good function but injury are at high risk of discard.Evaluating the CT angiogram of the kidney is a simple and effective tool to fully evaluate these kidneys for major parenchymaI injuries and determine true extent of injury. These organs often accumulate cold time which further increase the chance of discard.

*Methods: Analysis of two donors with traumatic injuries. Donor features such as age, weight, renal function, anatomy, serology, urine production. High refusal led to long cold time and discard risk. Based on these CT images: kidneys were accepted for transplant pending back table prep. The organ function and bleeding parameters are presented estimated blood loss (EBL), cold time and complications associated with use of these organs.

*Results: Donor A: 4-year-old brain dead donor fell from 10^th floor balcony. Splenic laceration, 50% parenchymal involvement AAST grade II injury. Laceration of right adrenal gland > 50% and parenchymal laceration 1.4 cm (AAST grade III injury). Donor B: 20-year-old MVC vs dump truck. Extensive TBI/IVH/SDH. Had splenectomy, left renal laceration grade III. Family elected to proceed with DCD. See table. Both kidneys functioned, no complications, no excess bleeding. Blood transfusion for post-operative hematocrit 19.3 lowest without hemodynamic changes in recipient of organ B. All organs showed graft function. Graft A: 5 months of follow up: baseline creat 1.3.

*Conclusions: CT scan images to visualized injured kidney provide additional source of information showing cortical integrity despite perinephric hematoma leading to increase utilization without adversely affecting patient or graft outcomes. The approach demonstrates feasibility in reducing discard of injured high-quality organs.

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