1Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, CA 94158 2Division of Nephrology, Department of Medicine, University of California, San Francisco, San Francisco, CA 94158 3Division of Nephrology, Department of Medicine, Vanderbilt University, Nashville, TN 37232 4Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109
TABLE OF CONTENTS
- 1. Abstract
- 2. Introduction
- 3. Growing a kidney in-situ: de novo organogenesis
- 4. Supplementing a failing kidney: cell transplantation
- 5. Growing a kidney in-vitro
- 5.1. Kidney factory: stem cells
- 5.2. Cloning a kidney: nuclear transplantation
- 6. Reseeding a kidney: decellularized scaffolds
7. Bioengineering a kidney
- 7.1. Renal assist device (RAD)
- 7.2. Bioartificial renal epithelial cell system (BRECS)
- 7.3. Implantable renal assist device (iRAD)
- 8. Discussion
- 9. Conclusion
- 10. Acknowledgements
- 11. References
Renal replacement therapy was an early pioneer in both extra-corporeal organ replacement and whole organ transplantation. Today, the success of this pioneering work is directly demonstrated in the millions of patients worldwide successfully treated with dialysis and kidney transplantation. However, there remain significant shortcomings to current treatment modalities that limit clinical outcomes and quality of life. To address these problems, researchers have turned to using cell-based therapies for the development of a bioartificial kidney. These approaches aim to recapitulate the numerous functions of the healthy kidney including solute clearance, fluid homeostasis and metabolic and endocrine functions. This review will examine the state-of-the-art in kidney bioengineering by evaluating the various techniques currently being utilized to create a bioartificial kidney. These promising new technologies, however, still need to address key issues that may limit the widespread adoption of cell therapy including cell sourcing, organ scaffolding, and immune response. Additionally, while these new methods have shown success in animal models, it remains to be seen whether these techniques can be successfully adapted for clinical treatment in humans.
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Send correspondence to: Steven H. Kim, University of California, San Francisco, Department of Medicine, Division of Nephrology, 521 Parnassus Ave, C443, Box 0532, San Francisco, CA 94143, Tel: 415-476-5714, Fax: 415-514-9656, E-mail: Steven.Kim@ucsf.edu