Huang Aaron J, Sharma Gaurav K, Parikh Rohan, Jin Zhaosheng, Darras Frank S, Bergese Sergio D
Department of Urology and Transplant Surgery, Stony Brook University Hospital, Stony Brook, NY 11794, USA.
Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA.
Curr Issues Mol Biol. 2025 Apr 17;47(4):282. doi: 10.3390/cimb47040282.
End-stage renal disease (ESRD) is a serious and lethal disease that carries with it a high morbidity and mortality rate if left untreated. Treating ESRD is conducted via renal replacement therapy and/or kidney transplantation, with the latter being the preferred option given the better outcomes and quality of life for the patients. However, as ESRD rises in prevalence, kidney transplantation rates remain largely unchanged. In every kidney transplantation, ischemia-reperfusion injury (IRI) is inevitable and the effect this has on the kidney depends based on donor type. IRI works through a variety of molecular mechanisms, primarily mitochondrial oxidative stress and programmed cell death mechanisms. Given the urgency to ensure the best outcomes for these limited kidney transplants, there has been a continued effort to find various potential therapeutic mechanisms to counteract IRI preoperatively, intraoperatively, and postoperatively. These include hypothermic machine perfusion, ischemic conditioning, nanoparticle removal of free radicals, peptide-based therapies, microRNA, and more. There is an ongoing effort to find the best way to mitigate IRI in kidney transplantation and this is being achieved through a better understanding of the molecular mechanisms of IRI.
终末期肾病（ESRD）是一种严重的致命疾病，如果不进行治疗，其发病率和死亡率都很高。ESRD的治疗通过肾脏替代疗法和/或肾移植进行，鉴于肾移植能为患者带来更好的治疗效果和生活质量，因此是首选方案。然而，随着ESRD患病率的上升，肾移植率基本保持不变。在每一次肾移植中，缺血再灌注损伤（IRI）都是不可避免的，其对肾脏的影响取决于供体类型。IRI通过多种分子机制起作用，主要是线粒体氧化应激和程序性细胞死亡机制。鉴于迫切需要确保这些有限的肾移植获得最佳效果，人们一直在不断努力寻找各种潜在的治疗机制，以在术前、术中和术后对抗IRI。这些机制包括低温机器灌注、缺血预处理、纳米颗粒清除自由基、基于肽的疗法、微小RNA等等。目前正在努力寻找减轻肾移植中IRI的最佳方法，这可以通过更好地理解IRI的分子机制来实现。
