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We hypothesized that flushing organs during procurement with cold preservation solutions could influence the number of donor blood cells retained in the allograft thereby exacerbating cold ischemic injury. We present the results of rat livers that underwent 24\u00a0h SCS after being flushed with a cold University of Wisconsin (UW) solution versus room temperature (RT) lactated ringers (LR) solution. These results were compared to livers that were not flushed prior to SCS and thoroughly flushed livers without SCS. We used viability and injury metrics collected during normothermic machine perfusion (NMP) and the number of retained peripheral cells (RPCs) measured by histology to compare outcomes. Compared to the cold UW flush group, livers flushed with RT LR had lower resistance, lactate, AST, and ALT at 6\u00a0h of NMP. The number of RPCs also had significant positive correlations with resistance, lactate, and potassium levels and a negative correlation with energy charge. 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Drs. Uygun and Tessier have provisional patent applications relevant to this study. Dr. Uygun has a financial interest in Organ Solutions, a company focused on developing organ preservation technology. Drs. Uygun and Tessier serve on the Scientific Advisory Board for Sylvatica Biotech Inc., a company focused on developing new preservation technologies. All competing interests are managed by the MGH and Partners HealthCare in accordance with their conflict-of-interest policies. No other authors have any competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23128"}}