Purpose: To establish the technique of ex vivo normothermic machine perfusion (EV NMP) and create a platform for reconditioning and evaluating marginal donor kidneys, with the aim of increasing kidney utilization and improving transplant outcomes. Methodology: A single-centre study was conducted using six non-utilized deceased donor kidneys. Three kidneys underwent EV NMP using a customized cardiopulmonary bypass machine, and three used the commercial Kidney Assist device. Perfusion quality was assessed using macroscopic evaluation, urine output, renal blood flow, and biochemical markers. Histopathological analysis was performed pre- and post-perfusion. Results: All six kidneys demonstrated viability with median urine output of 330 mL over 2 hours and macroscopic assessment scores of ≤3, indicating suitability for transplantation. Perfusate creatinine levels decreased significantly (p=0.02). Following this pilot, two marginal donor kidneys were further evaluated on EV NMP with intention for clinical transplantation. One kidney was accepted for clinical transplantation with satisfactory result. However, the other kidney was not utilized for clinical transplantation due to poor perfusion on macroscopic assessment scores. Conclusion: EV NMP is an emerging technology and promises further evaluation and reconditioning of marginal donor kidneys to increase utilization. This work has supported establishment of EV NMP at our centre, paving the way for clinical trials and future research into optimizing this technology for therapeutic interventions.