Delayed kidney allograft function - what does it tell us about acute kidney injury?

Ischemia-reperfusion (IR) injury plays a significant role in the pathogenesis of both delayed graft function (DGF) in allografts and hemodynamic mediated acute kidney injury (AKI) of native kidneys. IR injury involves the interplay of several factors, including both the innate and adaptive immune systems. Though the final effector mechanisms causing injury are likely similar in both allograft and native kidneys, DGF is confounded by various donor, recipient and graft-handling factors. DGF is becoming increasingly important because of the growing number of patients awaiting kidney transplant. Identifying mediators, new diagnostics and therapeutics for DGF is important to provide more kidneys for transplant and improve outcomes. Furthermore, given that DGF occurs in a tightly controlled scenario, studying DGF is useful for early studies of proof of principle for biomarkers and therapeutics prior to launching into less wellcontrolled studies in large numbers of native kidney AKI patients.