The lower aorta is cannulated. Either a major vein is cut to vent the venous blood or a cannula is placed in a major vein, for instance through the abdominal cava, care must be taken not to damage any of the donor veins that may be needed for transplantation. Portal perfusion may be performed through a cannula in the superior or inferior mesenteric veins. If the pancreas is for retrieval most will not perfuse the protal circulation as this causes pancreatic oedema. A recent US study has shown that aortic only perfusion does not compramise the quality of liver and pancreas grafts when compared with combined aortic and portal perfusion. [IOY$^+$96]
Once the cannulas are in place in the aorta and IVC the abdominal organs are cooled, while the cardiothoracic team completes the heart and lung retreival.