{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T22:54:55Z","timestamp":1792450495157,"version":"4.5.0"},"reference-count":42,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Chronic kidney disease (CKD) is a prevalent disease affecting almost 10% of the world\u2019s population, with many cases progressing to end-stage kidney disease (ESKD). Kidney transplantation (KT) is the gold-standard treatment for ESKD. Due to growing KT waitlists, the deceased kidney donor (DKDs) criteria have expanded to increase the number of available kidney grafts. Kidney graft preservation ensures optimal graft function after KT. Static cold storage (SCS) as a preservation method is still widely used. Hypothermic machine perfusion (HMP) has proven to decrease delayed graft function (DGF) and increase graft survival. Most recent studies advocate for the use of HMP regardless of donor type. However, emerging technologies, such as hypothermic oxygenated machine perfusion (HOPE) and normothermic machine perfusion (NMP), have shown promising results in specific scenarios. This review aims to provide a summary of the well-established kidney graft preservation methods and their outcomes, as well as novel technological advances that allow for newer preservation strategies.<\/jats:p>","DOI":"10.3390\/life14121647","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T12:58:49Z","timestamp":1733921929000},"page":"1647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Evolution of Kidney Graft Preservation Through the Years"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2503-9368","authenticated-orcid":false,"given":"Andres","family":"Calva Lopez","sequence":"first","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5698-641X","authenticated-orcid":false,"given":"Jose Enrique","family":"Robles Garcia","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Andres","family":"Yanez Ruiz","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Daniel","family":"Tapia Tapia","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2425-9795","authenticated-orcid":false,"given":"Vanessa","family":"Talavera Cobo","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmina Alejandra","family":"Mu\u00f1oz Bastidas","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1803-580X","authenticated-orcid":false,"given":"Daniel","family":"Sanchez Zalabardo","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-5650","authenticated-orcid":false,"given":"Bernardino","family":"Mi\u00f1ana Lopez","sequence":"additional","affiliation":[{"name":"Department of Urology, Cl\u00ednica Universidad de Navarra, 31008 Pamplona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.kisu.2021.11.003","article-title":"Epidemiology of Chronic Kidney Disease: An Update 2022","volume":"12","author":"Kovesdy","year":"2022","journal-title":"Kidney Int. Suppl."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"GBD Mortality Causes of Death Collaborators (2015). Global, Regional, and National Age\u2014Sex Specific All-Cause and Cause-Specific Mortality for 240 Causes of Death, 1990\u20132013: A Systematic Analysis for the Global Burden of Disease Study 2013. Lancet, 385, 117\u2013171.","DOI":"10.1016\/S0140-6736(14)61682-2"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Johansen, K.L., Gilbertson, D.T., Li, S., Li, S., Liu, J., Roetker, N.S., Ku, E., Schulman, I.H., Greer, R.C., and Chan, K. (2023). United States Renal Data System 2023 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).","DOI":"10.1053\/j.ajkd.2024.01.001"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Boenink, R., Kramer, A., Tuinhout, R.E., Savoye, E., \u00c5sberg, A., Idrizi, A., Kerschbaum, J., Ziedina, I., Ziginskiene, E., and Farrugia, E. (2023). Trends in Kidney Transplantation Rate across Europe: A Study from the ERA Registry. Nephrol. Dial. Transplant., 1528\u20131539.","DOI":"10.1093\/ndt\/gfac333"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1034\/j.1600-6143.3.s4.11.x","article-title":"Expanded Criteria Donors for Kidney Transplantation","volume":"3","author":"Metzger","year":"2003","journal-title":"Am. J. Transplant."},{"key":"ref_6","first-page":"113","article-title":"Ischemia\/Reperfusion","volume":"7","author":"Kalogeris","year":"2017","journal-title":"Compr. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1038\/ki.2014.359","article-title":"The Impact of Cold Ischemia Time on Renal Transplant Outcome","volume":"87","author":"Ponticelli","year":"2015","journal-title":"Kidney Int."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.acuro.2011.03.005","article-title":"Is There a Safe Cold Ischemia Time Interval for the Renal Graft?","volume":"35","author":"Barba","year":"2011","journal-title":"Actas Urol\u00f3gicas Espa\u00f1olas"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.ebiom.2018.01.025","article-title":"Ischemia-Reperfusion Injury Reduces Long Term Renal Graft Survival: Mechanism and Beyond","volume":"28","author":"Zhao","year":"2018","journal-title":"EBioMedicine"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Kvietkauskas, M., Leber, B., Strupas, K., Stiegler, P., and Schemmer, P. (2020). Machine Perfusion of Extended Criteria Donor Organs: Immunological Aspects. Front. Immunol., 11.","DOI":"10.3389\/fimmu.2020.00192"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E202","DOI":"10.1097\/TP.0000000000003679","article-title":"Advances in Kidney Preservation Techniques and Their Application in Clinical Practice","volume":"105","author":"Hosgood","year":"2021","journal-title":"Transplantation"},{"key":"ref_12","first-page":"322","article-title":"A New Perfusate for Kidney Preservation","volume":"33","author":"Belzer","year":"1982","journal-title":"Transplantation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/1010-7940(94)90117-1","article-title":"Experimental Evaluation of Celsior, a New Heart Preservation Solution","volume":"8","author":"Termignon","year":"1994","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2454","DOI":"10.1016\/j.transproceed.2005.06.030","article-title":"Kidney Transplantation From Elderly Donors: A Prospective Randomized Study Comparing Celsior and UW Solutions","volume":"37","author":"Montalti","year":"2005","journal-title":"Transplant. Proc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1111\/j.1600-6143.2011.03908.x","article-title":"Preservation Solutions for Static Cold Storage of Kidney Allografts: A Systematic Review and Meta-Analysis","volume":"12","author":"Knight","year":"2012","journal-title":"Am. J. Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1097\/00007890-200110150-00016","article-title":"Kidney Preservation with University of Wisconsin and Celsior Solution: A Prospective Multicenter Randomized Study","volume":"72","author":"Faenza","year":"2001","journal-title":"Transplantation"},{"key":"ref_17","first-page":"291","article-title":"24-Hour and 72-Hour Presernation of Canine Kidneys","volume":"2","author":"Belzer","year":"1967","journal-title":"Lancet"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1056\/NEJM196803142781108","article-title":"Successful Seventeen-Hour Preservation and Transplantation of Human-Cadaver Kidney","volume":"278","author":"Belzer","year":"1968","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1097\/TP.0b013e31829c24e2","article-title":"Role of Pulsatility in Hypothermic Reconditioning of Porcine Kidney Grafts by Machine Perfusion After Cold Storage","volume":"96","author":"Gallinat","year":"2013","journal-title":"Transplantation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1016\/j.transproceed.2017.05.011","article-title":"Hypothermic Machine Perfusion\u2019s Protection on Porcine Kidney Graft Uncovers Greater Akt-Erk Phosphorylation","volume":"49","author":"He","year":"2017","journal-title":"Transplant. Proc."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1097\/TP.0b013e3181cfa1d2","article-title":"A Comparison of Hypothermic Machine Perfusion versus Static Cold Storage in an Experimental Model of Renal Ischemia Reperfusion Injury","volume":"89","author":"Hosgood","year":"2010","journal-title":"Transplantation"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1097\/SLA.0b013e31815c4019","article-title":"Improved Kidney Graft Function After Preservation Using a Novel Hypothermic Machine Perfusion Device","volume":"246","author":"Maathuis","year":"2007","journal-title":"Ann. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/tri.12169","article-title":"One-Year Results of a Prospective, Randomized Trial Comparing Two Machine Perfusion Devices Used for Kidney Preservation","volume":"26","author":"Wszola","year":"2013","journal-title":"Transpl. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1056\/NEJMoa0802289","article-title":"Machine Perfusion or Cold Storage in Deceased-Donor Kidney Transplantation","volume":"360","author":"Moers","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1056\/NEJMc1111038","article-title":"Machine Perfusion or Cold Storage in Deceased-Donor Kidney Transplantation","volume":"366","author":"Moers","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1111\/j.1432-2277.2011.01232.x","article-title":"Machine Perfusion versus Cold Storage for Preservation of Kidneys from Expanded Criteria Donors after Brain Death","volume":"24","author":"Treckmann","year":"2011","journal-title":"Transpl. Int."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1097\/01.TP.0000438637.29214.10","article-title":"Pulsatile Perfusion Reduces the Risk of Delayed Graft Function in Deceased Donor Kidney Transplants, Irrespective of Donor Type and Cold Ischemic Time","volume":"97","author":"Gill","year":"2014","journal-title":"Transplantation"},{"key":"ref_28","first-page":"CD011671","article-title":"Machine Perfusion Preservation versus Static Cold Storage for Deceased Donor Kidney Transplantation","volume":"3","author":"Tingle","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1111\/aor.13364","article-title":"Hypothermic Machine Perfusion Versus Static Cold Storage in Deceased Donor Kidney Transplantation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"43","author":"Peng","year":"2019","journal-title":"Artif. Organs"},{"key":"ref_30","first-page":"CD011671","article-title":"Normothermic and Hypothermic Machine Perfusion Preservation versus Static Cold Storage for Deceased Donor Kidney Transplantation","volume":"7","author":"Tingle","year":"2024","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1097\/CCM.0b013e31817437ca","article-title":"Mild Therapeutic Hypothermia in Patients after Out-of-Hospital Cardiac Arrest Due to Acute ST-Segment Elevation Myocardial Infarction Undergoing Immediate Percutaneous Coronary Intervention","volume":"36","author":"Wolfrum","year":"2008","journal-title":"Crit. Care Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/ALN.0000000000000048","article-title":"Kidney Protection by Hypothermic Total Liquid Ventilation after Cardiac Arrest in Rabbits","volume":"120","author":"Tissier","year":"2014","journal-title":"Anesthesiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1056\/NEJMoa2118265","article-title":"Hypothermia or Machine Perfusion in Kidney Donors","volume":"388","author":"Malinoski","year":"2023","journal-title":"N. Engl. J. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1111\/j.1432-2277.2009.01014.x","article-title":"Hypothermic Reconditioning after Cold Storage Improves Postischemic Graft Function in Isolated Porcine Kidneys","volume":"23","author":"Koetting","year":"2010","journal-title":"Transpl. Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e128","DOI":"10.1097\/TP.0000000000002634","article-title":"Hypothermic Oxygenated Perfusion: A Simple and Effective Method to Modulate the Immune Response in Kidney Transplantation","volume":"103","author":"Kron","year":"2019","journal-title":"Transplantation"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1016\/S0140-6736(20)32411-9","article-title":"Oxygenated versus Standard Cold Perfusion Preservation in Kidney Transplantation (COMPARE): A Randomised, Double-Blind, Paired, Phase 3 Trial","volume":"396","author":"Jochmans","year":"2020","journal-title":"Lancet"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Meister, F.A., Czigany, Z., Rietzler, K., Miller, H., Reichelt, S., Liu, W.J., Boecker, J., Moeller, M.J., Tolba, R.H., and Hamesch, K. (2020). Decrease of Renal Resistance during Hypothermic Oxygenated Machine Perfusion Is Associated with Early Allograft Function in Extended Criteria Donation Kidney Transplantation. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-74839-7"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ravaioli, M., De Pace, V., Angeletti, A., Comai, G., Vasuri, F., Baldassarre, M., Maroni, L., Odaldi, F., Fallani, G., and Caraceni, P. (2020). Hypothermic Oxygenated New Machine Perfusion System in Liver and Kidney Transplantation of Extended Criteria Donors: First Italian Clinical Trial. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-70620-y"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jss.2012.08.001","article-title":"The Conditioning Effect of Ex Vivo Normothermic Perfusion in an Experimental Kidney Model","volume":"182","author":"Hosgood","year":"2013","journal-title":"J. Surg. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1002\/bjs.9894","article-title":"Ex Vivo Normothermic Perfusion for Quality Assessment of Marginal Donor Kidney Transplants","volume":"102","author":"Hosgood","year":"2015","journal-title":"Br. J. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Foguenne, M., MacMillan, S., Kron, P., Nath, J., Devresse, A., De Meyer, M., Michel, M., Hosgood, S., and Darius, T. (2023). Current Evidence and Future Perspectives to Implement Continuous and End-Ischemic Use of Normothermic and Oxygenated Hypothermic Machine Perfusion in Clinical Practice. J. Clin. Med., 12.","DOI":"10.3390\/jcm12093207"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1246","DOI":"10.1111\/ajt.12179","article-title":"Renal Transplantation After Ex Vivo Normothermic Perfusion: The First Clinical Study","volume":"13","author":"Nicholson","year":"2013","journal-title":"Am. J. Transplant."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/12\/1647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:52:58Z","timestamp":1760115178000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/14\/12\/1647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,11]]},"references-count":42,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["life14121647"],"URL":"https:\/\/doi.org\/10.3390\/life14121647","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,11]]}}}