BACKGROUND: The aim of the present study was to evaluate the effect of donor pre-treatment with atorvastatin in a model of brain death followed by prolonged cold preservation and allogeneic kidney transplantation in rats. MATERIAL/METHODS: Donor rats were pre-treated with atorvastatin or vehicle 2 days prior to induction of brain death. After a brain death period of 6h kidneys were explanted and stored for 24 h at 4°C in UW solution and transplanted into allogeneic recipients. Non brain dead rats treated with vehicle were ventilated for 6h prior to explantation and served as controls. Grafts were harvested after 10 days. RESULTS: Donor treatment of brain dead organ donors with atorvastatin had no influence on renal histology (Banff score) or renal inflammation compared to vehicle treated brain dead rats 10 days after cold preservation and allogeneic transplantation. Grafts from brain dead organ donors showed severe signs of vasculopathy compared to grafts from non brain dead organ donors 10 days after prolonged cold preservation and allogeneic kidney transplantation. Kidneys harvested after brain death before cold preservation and allogeneic transplantation showed an increased infiltration of ED1 and MHCII positive cells compared to kidneys of non-brain dead animals (NBD). CONCLUSIONS: Atorvastatin donor pre-treatment of brain dead organ donors combined with 24h of cold preservation has no influence on graft rejection and infiltration with ED1 or MHCII positive cells in an allogeneic rat renal transplantation model. The detrimental combination of brain death and cold preservation might have overcome the possible protective effect of atorvastatin donor pre-treatment.