Transcriptome Analysis of Kidney Grafts Subjected to Normothermic Ex-Vivo Kidney Perfusion

Normothermic ex-vivo kidney perfusion (NEVKP) has demonstrated superior outcomes for donation-after-cardiovascular death (DCD) grafts compared to static cold storage (SCS). To determine the mechanisms responsible for this, we performed an unbiased genome-wide microarray analysis. Kidneys from 30kg-Yorkshire pigs were subjected to 30min of warm ischemia followed by 8hrs of NEVKP or SCS, or no storage (NS), prior to auto-transplantation. mRNA expression was analyzed on POD3 renal biopsies. Porcine right sided kidneys were subjected to 30minutes warm ischemia, then removed and flushed. For the No Storage group (N=3 animals), the kidneys were immediately re-implanted. In the SCS group (N=3 animals), the kidneys were subjected to 8 hours of static cold storage prior to auto-transplantation. In the NEVKP group (N=3 animals), the kidneys were subjected to 8 hours of Normothermic Ex-Vivo Kidney Perfusion prior to auto-transplantation. In all animals (N=9), the contralateral (left) kidney was removed at the time of auto-transplantation. Kidney biopsies were collected at post-operative day 3 and subjected to expression profiling by microarray. To characterize the gene expression changes, comparisons were made between SCS and NS, NEVKP and NS respectively, as well as between NEVKP and SCS.