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How to Best Protect Kidneys for Transplantation—Mechanistic Target

The increasing number of patients on the kidney transplant waiting list underlines the need to expand the donor pool and improve kidney graft utilization. By protecting kidney grafts adequately from the initial ischemic and subsequent reperfusion injury occurring during transplantation, both the num...

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Autores principales: Akalay, Sara, Hosgood, Sarah A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003664/
https://www.ncbi.nlm.nih.gov/pubmed/36902572
http://dx.doi.org/10.3390/jcm12051787
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author Akalay, Sara
Hosgood, Sarah A.
author_facet Akalay, Sara
Hosgood, Sarah A.
author_sort Akalay, Sara
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description The increasing number of patients on the kidney transplant waiting list underlines the need to expand the donor pool and improve kidney graft utilization. By protecting kidney grafts adequately from the initial ischemic and subsequent reperfusion injury occurring during transplantation, both the number and quality of kidney grafts could be improved. The last few years have seen the emergence of many new technologies to abrogate ischemia–reperfusion (I/R) injury, including dynamic organ preservation through machine perfusion and organ reconditioning therapies. Although machine perfusion is gradually making the transition to clinical practice, reconditioning therapies have not yet progressed from the experimental setting, pointing towards a translational gap. In this review, we discuss the current knowledge on the biological processes implicated in I/R injury and explore the strategies and interventions that are being proposed to either prevent I/R injury, treat its deleterious consequences, or support the reparative response of the kidney. Prospects to improve the clinical translation of these therapies are discussed with a particular focus on the need to address multiple aspects of I/R injury to achieve robust and long-lasting protective effects on the kidney graft.
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spelling pubmed-100036642023-03-11 How to Best Protect Kidneys for Transplantation—Mechanistic Target Akalay, Sara Hosgood, Sarah A. J Clin Med Review The increasing number of patients on the kidney transplant waiting list underlines the need to expand the donor pool and improve kidney graft utilization. By protecting kidney grafts adequately from the initial ischemic and subsequent reperfusion injury occurring during transplantation, both the number and quality of kidney grafts could be improved. The last few years have seen the emergence of many new technologies to abrogate ischemia–reperfusion (I/R) injury, including dynamic organ preservation through machine perfusion and organ reconditioning therapies. Although machine perfusion is gradually making the transition to clinical practice, reconditioning therapies have not yet progressed from the experimental setting, pointing towards a translational gap. In this review, we discuss the current knowledge on the biological processes implicated in I/R injury and explore the strategies and interventions that are being proposed to either prevent I/R injury, treat its deleterious consequences, or support the reparative response of the kidney. Prospects to improve the clinical translation of these therapies are discussed with a particular focus on the need to address multiple aspects of I/R injury to achieve robust and long-lasting protective effects on the kidney graft. MDPI 2023-02-23 /pmc/articles/PMC10003664/ /pubmed/36902572 http://dx.doi.org/10.3390/jcm12051787 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Akalay, Sara
Hosgood, Sarah A.
How to Best Protect Kidneys for Transplantation—Mechanistic Target
title How to Best Protect Kidneys for Transplantation—Mechanistic Target
title_full How to Best Protect Kidneys for Transplantation—Mechanistic Target
title_fullStr How to Best Protect Kidneys for Transplantation—Mechanistic Target
title_full_unstemmed How to Best Protect Kidneys for Transplantation—Mechanistic Target
title_short How to Best Protect Kidneys for Transplantation—Mechanistic Target
title_sort how to best protect kidneys for transplantation—mechanistic target
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10003664/
https://www.ncbi.nlm.nih.gov/pubmed/36902572
http://dx.doi.org/10.3390/jcm12051787
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