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About 100 ml. of preserving fluid is infused into the kidney, which is then inserted into a polyethylene bag containing about 100 ml. of cold saline. The bag is occluded with an elastic band and inserted into another sterile polyethylene bag also containing a little cold saline. The second bag is similarly occluded, and the left kidney, in its two bags surrounded by cold saline, is inserted into a vacuum flask clearly labelled " left kidney." Ice cubes are gently packed around the outer polyethylene bag, which is not sterile on the outside. The exact time of death of the donor, the time of removal of the kidney, its anatomy, and its perfusion are recorded on a special form. The peritoneum lateral to the ascending colon is now divided and the right kidney is removed in a similar manner to the left, perfused, and preserved in the same way. Any anatomical abnormality is accurately recorded on the form. The kidneys are now transported to the nearest transplant centres where there are recipients of a suitable tissue match. The abdominal incision in the cadaver is closed. Any abnormalities noted by the surgeon will be reported to the coroner's pathologist if the case is under the coroner's jurisdiction. The removal of a kidney is not an easy operation; it is often performed by relatively inexperienced surgeons in the middle of the night with few assistants and perhaps poor equipment. Kidney removal sets should include deep retractors, long scissors, and clamps. Suction apparatus is very useful to remove the blood that accumulates when the renal vessels are divided. If the kidney is damaged in any way it is important that the nature of the damage be recorded on the form provided. The best way to train surgeons in the removal of kidneys is for them to spend some time at a transplant centre learning the techniques. Furthermore, it is advisable that they should know something of the operative procedures performed on the recipient, to enable them to appreciate how the manner of removing the kidney can modify the insertion of the organ.