The role of hypoxia-inducible factors in organ donation and transplantation: The current perspective and future opportunities

Hypoxia-inducible factors are the universal cellular oxygen-sensitive transcription factors that activate a number of hypoxia responsive genes, some of which are responsible for protective cellular functions. During organ donation, allografts are exposed to significant periods of hypoxia and ischemia. Exploiting this pathway during donor management and organ preservation could prevent and reduce allograft injury and improve the outcomes of organ transplantation. We review the evidence on this pathway in organ preservation, drawing on experimental studies on donor management and ischemia reperfusion injury focusing on kidney, liver, cardiac and lung transplantation. We review the major technical and experimental challenges in exploring this pathway and suggest potential future avenues for research. The authors provide a descriptive review of the current experimental evidence relevant to the role of the Hypoxia Inducible Factor system in organ donation and transplantation. © Copyright 2014 The American Society of Transplantation and the American Society of Transplant Surgeons.