Protection of grafts from ischemia-reperfusion injury (IRI) remains an important problem, especially in uncontrolled donors. This study was performed to define the effect of oxygenated perfluorocarbonic emulsion for initial in situ conservation. One hundred and seventeen kidney grafts were procured from 2003 until 2006 from sixty one DCDs of Maastricht II and IV category. Control group donors (HTK group, n = 31) were operated using the traditional rapid laparotomy. The study group donors (Perftoran group, n = 30) had femoral access obtained in the ICU with initial perfusion by perfluorocarbonic PFG emulsion. The recipients were divided according to the type of the initial perfusion of the kidneys into a control group (n = 59) whose kidneys were initially perfused using HTK solution, and a study group (n = 58), who received kidneys preserved with initial perfusion in situ using oxygenated Perftoran. The rate of delayed graft function was significantly (up to 30%) higher among the control group. In the study group, the rate of immediate function was twice as high as that in the control group. By postoperative day 21, the level of serum creatinine in the study group decreased twice that of the control group. Initial perfusion with oxygenated perfluorocarbonic emulsion in situ may minimize a IRI of DCD kidneys.