Static Storage at 10°C Improves Early Graft Function and Alters Extracellular Matrix Programs in Porcine Kidneys

ABSTRACT: Static storage at 10°C improves early graft function in thoracic transplantation, but kidney-specific evidence is limited. We compared 10°C and ice static storage in a porcine en bloc model followed by acellular normothermic machine perfusion (NMP). Kidneys were procured, stored for 24 hours on ice or at 10°C (N = 3 per group), and reperfused for 2 hours of NMP. Hemodynamic and tubular function were assessed continuously, and cortex and medulla were characterized by histology, electron microscopy, bulk RNA sequencing, and untargeted metabolomics. By 120 minutes of NMP, 10°C grafts showed higher blood flow, lower intrarenal resistance, greater oxygen consumption, and greater urine output than ice-stored grafts. Urinary NGAL and mitochondrial DNA were lower in the 10°C group. Electron microscopy showed preserved apical brush border architecture in 10°C grafts. Cortical transcriptomics showed enrichment of oxidative phosphorylation and fatty acid metabolism in 10°C grafts, while ice-stored grafts showed upregulation of gene programs associated with extracellular matrix turnover. Glycosaminoglycan degradation was the primary metabolic signature distinguishing the two groups in both cortex and medulla, enriched in ice-stored grafts. Storage at 10°C improves early renal graft performance and is accompanied by distinct differences in extracellular matrix metabolism.

ORGANISM(S): Sus scrofa

PROVIDER: GSE344667 | GEO | 2026/08/25

REPOSITORIES: GEO