Related Experiment Video

Updated: Sep 12, 2025

Renal Ischaemia Reperfusion Injury: A Mouse Model of Injury and Regeneration
12:27

Renal Ischaemia Reperfusion Injury: A Mouse Model of Injury and Regeneration

Published on: June 7, 2014

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Emerging Therapeutic Strategies for Renal Ischemia-Reperfusion Injury in Kidney Transplantation: Progress and

Sohail Khan1, Dayanna Zuluaga1, Lloyd E Ratner2

  • 1Department of Primary Care, Touro College of Osteopathic Medicine, Middletown, New York, USA.

Clinical Transplantation
|August 4, 2025
PubMed
Abstract

Insights

Investigational therapies for kidney transplant ischemia-reperfusion injury (IRI) show promise, but most remain preclinical. Future research needs standardized models and biomarkers to advance treatments for delayed graft function.

Area of Science:

  • Nephrology
  • Transplantation Immunology
  • Pharmacology

Background:

  • Ischemia-reperfusion injury (IRI) is a major cause of delayed graft function and long-term kidney transplant loss.
  • No pharmacological strategy has successfully translated into clinical practice for renal IRI (RIRI).

Purpose of the Study:

  • To systematically review investigational pharmacologic therapies for RIRI in kidney transplantation (KTx) reported since 2000.

Main Methods:

  • Systematic search of PubMed, ClinicalTrials.gov, and EUCTR (2000-2025).
  • Inclusion of preclinical and clinical studies on pharmacologic RIRI interventions in KTx.
  • Exclusion of narrative reviews, pediatric-only, in silico-only, and in vitro-only studies.
  • Synthesis of 43 included reports by mechanism of action, developmental stage, and translational status.

Main Results:

  • Legacy agents (Diannexin, YSPSL, I5NP) failed late-phase clinical trials.
  • Emerging therapies include alkaline phosphatase, complement inhibitors, and MSC-derived exosomes, mostly in early development.
  • Most data are preclinical, with inconsistent outcome measures and translational challenges.

Conclusions:

  • Significant translational bottlenecks and limited preclinical data hinder clinical application.
  • Future research should focus on harmonized animal models and biomarker-defined endpoints.
  • Strategic investment is needed to advance promising RIRI therapies for kidney transplant recipients.
Keywords:
delayed graft functiondrug developmentischemia‐reperfusion injurykidney transplantationorgan preservationpharmacologic therapiestranslational research

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