A comprehensive proteomic and transcriptomic mapping study found porcine and human kidneys exhibit a profoundly altered biological profile during warm ex vivo perfusion

The authors aimed to investigate the molecular changes occurring in porcine and human kidneys during normothermic machine perfusion (NMP) and how these changes differ from in vivo physiology. Their comprehensive proteomic and transcriptomic analysis revealed extensive transcriptional reprogramming and gradual proteomic alterations, indicating that NMP induces significant biological remodeling that cannot be solely attributed to donor characteristics. This study highlights the need to consider ex vivo-specific responses when assessing kidney viability during perfusion, challenging the reliance on in vivo biomarkers.