**4.1. Liver**

The liver is inspected in the basin. Five hundred milliliter of UW solution (4°C) is perfused to the portal vein system. The common bile duct is flushed with 200 ml of UW solution by using a syringe. The liver is placed into the first sterile bag filled with 700–1000 ml of UW solution, and the bag is tied. The first bag is then placed into the second sterile bag filed with 1 L cold normal saline and tied. The second bag is placed into the third sterile bag and then tied. The liver in the three-layered bag is then placed in the Iskey filled with ice blocks for transportation to the recipient hospital with the document secured in the Iskey (**Figure 10**) [7].

#### **4.2. Pancreas**

The pancreas is inspected to ensure its quality for transplantation without injury from the procurement and then is packed by the same method as for the liver. It is placed in the Iskey with retrieved vessels for transportation to the recipient hospital. Often, the pancreas is allocated with the left kidney to the same recipient for simultaneous pancreas-kidney transplantation (SPKT). Care is taken to avoid manipulation over the pancreas. Perfusion to the pancreas on the back table is not recommended to avoid perfusion injury and pancreatitis.

**Figure 10.** Package of the liver. The first bag filled with UW solution.
