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As a result, more kidney grafts from marginal donors are being considered for transplantation, with concomitantly more initial graft injury and limited organ and patient survival. This has led to an increased need for interventions aiming to optimize and preserve graft quality. Interventions within the donor may protect against ischemia\/reperfusion injury, and therefore, donor pre\u2010treatment is a promising strategy to increase graft function and survival. During the last decade, diverse donor pre\u2010treatment interventions have been explored in animal studies. Moreover, the first human trials concerning donor pre\u2010treatment in kidney transplantation have provided encouraging results. Unfortunately, it remains difficult to determine how and where to intervene in the multifactorial and complex processes that affect the donor kidney. Moreover, ethical matters play a critical role in donor interventions, and pre\u2010treatment should principally not have any potentially unfavorable effects on other organs to be transplanted or on the living donor. This review provides an overview of promising therapeutical strategies for donor pre\u2010treatment in kidney transplantation and discusses the clinical trials that have been conducted thus far.<\/jats:p>","DOI":"10.1111\/ctr.12261","type":"journal-article","created":{"date-parts":[[2013,10,16]],"date-time":"2013-10-16T10:42:40Z","timestamp":1381920160000},"page":"799-808","source":"Crossref","is-referenced-by-count":16,"title":["Donor pre\u2010treatment in clinical kidney transplantation: a critical appraisal"],"prefix":"10.1111","volume":"27","author":[{"given":"Dorottya K.","family":"de Vries","sequence":"first","affiliation":[{"name":"Department of Surgery Leiden University Medical Center Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonie G. 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