The renal transcriptome differs between donors after circulatory death and donors after brain death, which may influence the efficience of ischemic preconditioning

editorial reviewedObjective The prevention/attenuation of graft ischemic injury is a challenge in kidney transplantation. We developed two rat models to investigate the impact of mesenchymal stromal cells (MSCs) in the ischemic preconditioning of kidneys from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD). Methods Under general anesthesia, rats underwent iv injection of saline (S-groups) or 1.5 106 MSCs (MSC-groups) followed by either DBD (6hr of brain death) or DCD (6hr of anesthesia and 20min warm ischemia) models, resulting in 4 groups (S-DBD, S-DCD, MSC-DBD, MSCDCD). Kidneys were then procured after IGL1 flush. One kidney was directly fixed and the other one immersed for 14 hours in IGL1 at 4°C. Serum samples were collected before treatment (baseline) and at the time of kidney collection. Urine samples were collected by bladder puncture at the time of kidney collection. Renal function was evaluated. Kidney histology was assessed by PAS staining and KIM1 immunostaining. Total RNA was extracted from S-DCD vs S-DBD kidneys for RNAseq. Results BUN was increased after 6h of anesthesia (DCD) or brain death (DBD) (p