The main problem of transplantology is deficit of organs. A renewal interest to using non heart beating (as too as marginal) donors is connected with the ischemic-reperfusion injury complications. Circumstances of explantation restrict the opportunities of using this kind of transplants because there are initial defects caused by ischemic damages. Using the machine perfusion enables to maximize the acceptance of marginal kidneys as the result of summarizing the processes of diagnoses, selection, treatment of kidney transplants during conservation.