 Distant organ injury is a frequent consequence of cardiovascular surgery involving cardio-pulmonary bypass. Acute kidney injury AKI, the most common complication, occurs in 30-40 of cardiac surgery patients and, even with moderate damage, significantly increases mortality and healthcare costs. Although organ injury has been linked to inflammation, the mechanisms that initiate and propagate these events remain poorly defined. As the median age and medical complexity of cardiac patients increases, the challenge - and opportunity - to improve organ protection lies in identifying modifiable targets. 