REVIEW article
Front. Pharmacol.
Sec. Renal Pharmacology
This article is part of the Research TopicAdvancing Machine Perfusion: Navigating Challenges in Abdominal Organ TransplantationView all articles
Improving kidney transplantation by pharmacological addition of the hypothermic preservation solution: a scoping review
Provisionally accepted
Vincent MAYORAL1,2*
Tom DARIUS3,4
Sarah BRUNEAU2
Christophe Masset2Jerome RIGAUD5Gilles BLANCHO2
Thomas PRUDHOMME2Julien Branchereau2,5
Benoît Mesnard2,5- 1Centre Hospitalier Universitaire (CHU) de Rouen, Rouen, France
- 2Centre de Recherche en Transplantation et Immunologie, Nantes, France
- 3Cliniques universitaires Saint-Luc, Brussels, Belgium
- 4Universite catholique de Louvain Institut de Recherche Experimentale et Clinique, Brussels, Belgium
- 5Centre Hospitalier Universitaire de Nantes, Nantes, France
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The rising use of extended kidney grafts to bridge organ shortage increased delayed and impaired graft function, with the need to develop new preservation strategies. Besides hypothermic machine perfusion, pharmacological treatment additives to the preservation solution have been increasingly investigated, with a broad spectrum of agents. This review aimed to identify and summarize current literature on pharmacological treatment additives for hypothermic kidney graft preservation. A scoping review was conducted according to the PRISMA-ScR guidelines. A comprehensive literature search was performed using Medline and Cochrane library databases until December the 1st, 2023. All English-language studies reporting on pharmacological supplementation of the solution to improve hypothermic kidney graft preservation were included. 67 records were retrieved, of which all were preclinical but one. Among them, 8 were conducted on cellular models, 21 on ex vivo kidneys and 38 on animal kidney transplantations. 40 pharmacological agents were evaluated based on key markers of ischemia reperfusion injury pathophysiology, most of them improving kidney preservation. While promising, with numerous preclinical studies on various effective additives identified, pharmacological treatment additive strategy to improve hypothermic kidney preservation is still lacking translation into the clinic. Promotion of clinical investigations should be supported, as for the few hopeful ongoing trials.
Keywords: Kidney Transplantation, Organ Preservation, Drug Therapy, Tissue donor, Reperfusion Injury
Received: 25 Aug 2025; Accepted: 30 Nov 2025.
Copyright: © 2025 MAYORAL, DARIUS, BRUNEAU, Masset, RIGAUD, BLANCHO, PRUDHOMME, Branchereau and Mesnard. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Vincent MAYORAL
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