By 2030, 1 million people in the United States will have end-stage renal disease. Kidney transplantation is a critically important intervention for these individuals: transplantation improves survival, quality of life, and healthcare costs compared to maintenance dialysis.2–5  Regrettably, the supply of transplantable organs remains inadequate. Hence, optimization of the short-term and long-term function of transplanted kidneys is critically important. Transplanted kidneys are vulnerable to acute kidney injury (AKI) related to hemodynamic instability, hypovolemia, immunologic injury, and ischemia-reperfusion injury. After 25 to 30% of deceased donor kidney transplantation procedures in the United States, such perioperative AKI leads to delayed graft function,10  which is typically defined as the need for dialysis within a week after transplantation. This incidence is likely to increase even further with increased reliance on marginal kidneys from expanded...

You do not currently have access to this content.