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Updated: Jun 30, 2026

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Kidney Metabolism During Normothermic Machine Perfusion Differs Substantially From In Vivo Conditions.

Baran Ogurlu1, L Annick van Furth1, You Zuo1

  • 1Department of Surgery-Organ Donation and Transplantation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

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|December 3, 2025
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Summary
This summary is machine-generated.

Normothermic machine perfusion (NMP) alters kidney metabolism, increasing amino acid breakdown and decreasing pyrimidine metabolism. These metabolic shifts are linked to heightened immune responses and cell death during ex vivo preservation.

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Area of Science:

  • Organ transplantation research
  • Biomedical engineering
  • Renal physiology

Background:

  • Normothermic machine perfusion (NMP) is a promising technique for assessing deceased-donor kidney viability.
  • Understanding ex vivo kidney metabolism is crucial for optimizing NMP.
  • Warm ischemia's impact on ex vivo kidney metabolism requires further investigation.

Purpose of the Study:

  • To explore metabolic differences between ex vivo and in vivo kidneys.
  • To assess the impact of warm ischemia on ex vivo kidney metabolism.
  • To investigate the link between metabolic alterations and cellular processes during NMP.

Main Methods:

  • Multiomics approach (metabolomics, transcriptomics, proteomics) applied to pig kidneys.
  • Comparison of kidneys with minimal vs. 75-minute warm ischemia.
  • Analysis of kidney tissue collected in vivo, after cold preservation, and after NMP.

Main Results:

  • NMP altered kidney metabolism, increasing branched-chain amino acid metabolism and decreasing pyrimidine metabolism.
  • Enhanced glycolysis, reduced gluconeogenesis, impaired TCA cycle, and NAD+ depletion observed.
  • Metabolic changes correlated with increased immune response and cell death during NMP.

Conclusions:

  • Significant metabolic differences exist between in vivo and ex vivo kidneys.
  • NMP induces metabolic alterations linked to potentially detrimental cellular processes.
  • Findings highlight the need for strategies to mitigate ex vivo metabolic changes.