Kidney regeneration: Where we are and future perspectives

Area of Science:

• Regenerative Medicine
• Biomedical Engineering
• Nephrology

Background:

• High demand for kidney transplants and graft failure highlight limitations of current renal replacement therapies.
• Approximately 40% of kidney transplant recipients experience graft loss or mortality within 10 years.
• Developing alternative strategies to improve, restore, or replace renal function is critical for end-stage renal disease (ESRD) patients.

Purpose of the Study:

• To outline a strategic approach for kidney regeneration.
• To review current literature on cell sources and mechanisms for bioengineered kidney development.
• To explore the potential of cell-scaffold technology in creating functional bioengineered kidneys.

Main Methods:

• Utilizing extracellular matrix (ECM) based scaffolds, leveraging the kidney's unique anatomy.
• Employing detergent perfusion for kidney decellularization, removing cellular material while preserving ECM structure.
• Investigating reliable cell sources for seeding scaffolds and maturation in bioreactors simulating physiological conditions.

Main Results:

• Decellularization via detergent perfusion is an effective method for preparing kidney scaffolds.
• Identifying and culturing suitable cell sources are crucial for creating stable renal cell systems.
• Maturation of seeded cells within bioreactors is essential for developing functional bioengineered organs.

Conclusions:

• Bioengineered kidneys represent a promising future therapy for ESRD patients, potentially reducing reliance on dialysis and immunosuppression.
• While significant progress has been made in solid organ regeneration, achieving a fully functional bioengineered kidney remains a substantial scientific challenge.
• Cell-scaffold technology offers a viable path towards generating a reliable source of transplantable, refunctionalized organs.