End-stage renal illness is best treated by kidney transplantation. However, because of the scarcity of organs, inferior transplants are increasingly being employed. Researchers conducted a study of organ optimization methods and strategies in the cadaveric context. The initial link in a chain of care is donor care. There are a number of changes that occur immediately following brain death, the most important of which are hormonal and hemodynamic alterations. Several studies have been undertaken to decide which medications to provide, however, the findings are not always conclusive. The major goal appears to be to achieve a set of biochemical and hemodynamic goals. Ischemia-reperfusion injury is a major cause of kidney impairment after transplantation. Preconditioning is one method for dealing with this sort of injury. Local and distant ischemia preconditioning has been researched for a variety of organs, however, research on the kidney is limited. Pharmacological preconditioning is a new promising area that is just getting started. The primary surgical procedures were developed in the late twentieth century. Minor changes have been made to deal with anatomical differences or the development of donation following circulatory death. Finally, following harvesting, it is critical to maintaining the optimal circumstances for the kidneys until transplantation. Much has changed since static cold preservation, but the ideal conditions for preservation have yet to be established.