Preservation of the kidney by carbon monoxide: a black swan phenomenon.

Nakao and colleagues demonstrate that carbon monoxide added to organ preservation solution reduces donor-kidney injury that occurs after cold storage and transplantation and improves the survival of the recipient. These findings are important because they highlight the role of the cytochrome P450 system in the pathogenesis of donor-kidney injury and they suggest a strategy for preserving the donor kidney, namely, the addition of carbon monoxide to organ preservation solution.