Kidney transplantation has become a lifesaver for patients worldwide. The major organ sources are brain dead donors (BDD). Accumulating evidence suggests that brain death contributes to an impairment of renal function and to nephron loss by acute tubular necrosis (ATN). Together with the surgical procedure, this inevitably results in acute kidney injury (AKI). Devising appropriate models to study brain death-induced AKI and associated delayed graft function (DGF) is technically challenging. In this issue of the American Journal of Transplantation, Giraud and Kerforne et al use a preclinical model of porcine kidney transplantation to study the mechanisms of brain death-induced AKI. 1 The same group previously reported that the eukaryotic initiation factor 5A (eIF5A) hypusination inhibitor N1-guanyl-1,7-diaminoheptane (GC7), a spermidine analog, protects porcine kidneys from ischemic renal injury. 2 They demonstrated that GC7 induced a marked reduction in OXPHOS mitochondrial activity, most likely by selectively targeting components of the respiratory chain complexes 2 and thus reducing the generation of reactive oxygen species (ROS). ROS cause lipid peroxidation and ATN by regulated cell death (RCD) processes. 3 This destructive process is catalyzed by free iron and causes mitochondrial fragmentation and the cellular energetic breakdown, features that are typical of ferroptosis. 4 This differs from apoptosis where the plasma membrane stays intact, and from all other known cell death pathways in that it results in synchronized regulated necrosis (SRN) of nephrons beyond a single cell level, explaining the phenomenon of nephron loss. 5 The necrotic nature of ATN is associated with the release of damage-associated molecular patterns (DAMPs) that drive rejection of transplanted organs. 6 Transplantation of nonnecrotic organs through pharmacological prevention of ATN, for example, by GC7, should therefore result in favorable outcome. Giraud and Kerforne et al induced slow brain death in pigs and then carefully investigated potential hemodynamic changes following application of GC7 (Figure 1). The mean arterial pressure and cardiac output remained unaffected by the compound.