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How to Best Protect Kidneys for Transplantation-Mechanistic Target

Sara Akalay1, Sarah A Hosgood2

  • 1Department of Development and Regeneration, Laboratory of Pediatric Nephrology, KU Leuven, 3000 Leuven, Belgium.

Journal of Clinical Medicine
|March 11, 2023
PubMed

Insights

Protecting kidney grafts from ischemia-reperfusion (I/R) injury is crucial for improving transplantation outcomes. New technologies like machine perfusion and organ reconditioning offer promising strategies to enhance kidney graft utilization.

Area of Science:

  • Nephrology
  • Transplantation immunology
  • Regenerative medicine

Background:

  • Growing kidney transplant waiting lists necessitate improved donor pool and graft utilization.
  • Ischemia-reperfusion (I/R) injury significantly impacts kidney graft quality and survival post-transplantation.
  • Emerging technologies aim to mitigate I/R injury, but a translational gap exists for reconditioning therapies.

Purpose of the Study:

  • To review current knowledge on the biological mechanisms of kidney I/R injury.
  • To explore existing and novel strategies for preventing and treating I/R injury in kidney transplantation.
  • To discuss prospects for clinical translation of I/R injury mitigation therapies.

Main Methods:

  • Comprehensive literature review of I/R injury in kidney transplantation.
  • Analysis of emerging technologies: machine perfusion and organ reconditioning.
  • Discussion of biological processes and therapeutic interventions.

Main Results:

  • I/R injury involves complex biological processes impacting kidney grafts.
  • Machine perfusion is transitioning to clinical use, while reconditioning therapies remain experimental.
  • A multi-faceted approach is needed to address I/R injury effectively.

Conclusions:

  • Addressing multiple facets of I/R injury is essential for robust, long-lasting kidney graft protection.
  • Bridging the translational gap for organ reconditioning therapies is critical for clinical advancement.
  • Optimizing I/R injury management can significantly improve kidney graft utilization and patient outcomes.
Keywords:
ischemia–reperfusion injurykidney preservationkidney reconditioningmachine perfusion

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