An analysis of 130 consecutive cadaveric renal transplants has shown the effectiveness of simple surface cooling of organs before transplantation. The primary graft failure rate was 10%, and kidneys could be stored for periods of up to 12 hours including warm ischaemia times of 150 minutes. Forty-eight patients received haemodialysis before transplantation and 78 patients received peritoneal dialysis. There were significant differences in the incidence of tubular necrosis in the two groups: these may have been linked to the differences in fluid and osmotic load presented to the transplants.