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Polyethylene glycol 35 (PEG35) is a water-soluble, non-immunogenic, and non-toxic polymer of ethylene glycol with an average molecular weight of 35 kDa. It is widely utilized as an oncotic and cytoprotective agent in organ preservation solutions, such as Institut Georges Lopez-1 (IGL-1), IGL-2, and IGL-2M, to prevent cell swelling, maintain membrane integrity, and reduce ischemia-reperfusion injury during static cold storage and machine perfusion of transplant grafts (including liver, kidney, and lung). Beyond its biophysical role as an osmotic/oncotic agent, PEG35 activates several cytoprotective and cell-survival pathways, including AMP-activated protein kinase (AMPK), endothelial nitric oxide synthase (eNOS) for nitric oxide production, and the Nrf2/HO-1 antioxidant response. Additionally, PEG35 is under preclinical investigation as an intravenous therapeutic agent to ameliorate inflammation and cell death in acute necrotizing pancreatitis and associated lung injury.
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