RNA interference in organ transplantation: Next-generation medicine?

Ischemia-reperfusion injury (IRI) is a major factor in graft quality and organ function after transplantation. Gene silencing through RNA interference (RNAi) may be used to suppress genes related to IRI and modify a graft before transplantation. RNAi is a natural process of posttranscriptional gene regulation that gained a lot of attention after winning the Nobel Prize in Medicine in 2006. Hence, several strategies have been used to deliver siRNA, and pretransplant machine perfusion presents a unique opportunity to deliver siRNA to the target organ during ex situ preservation. This book chapter discusses RNAi in the field of organ transplantation and considers whether this technique may be used as next-generation medicine. It gives a brief overview of the discovery of RNAi and its mechanism of action. In addition, studies using RNAi to target genes related to IRI in liver, kidney, lung, and heart transplantation are discussed.