Whole kidney engineering for clinical translation.

Area of Science:

• Biomedical Engineering
• Regenerative Medicine
• Organ Transplantation

Background:

• End-stage renal disease (ESRD) treatment relies on transplantation, limited by donor organ scarcity.
• Bioengineering kidneys via decellularization-recellularization offers a potential solution.
• Current research primarily uses rodent models with short-term evaluations.

Purpose of the Study:

• To review the progress and challenges in engineering transplantable kidneys.
• To identify key advancements in scaffold fabrication and cell sourcing.
• To discuss strategies for clinical translation of bioengineered kidneys.

Main Methods:

• Utilizing decellularization and recellularization techniques for kidney bioengineering.
• Employing human-sized scaffolds from porcine and discarded human kidneys.
• Investigating various cell sources, including stem cells and primary renal cells.

Main Results:

• Feasibility of fabricating human-sized renal scaffolds demonstrated.
• Successful recellularization using embryonic stem cells, induced pluripotent stem cells, and primary renal cells.
• Development of antithrombogenic strategies for long-term implantation, such as reendothelialization.

Conclusions:

• Whole kidney bioengineering has made initial strides toward clinical application.
• Significant challenges remain in achieving successful patient treatment for ESRD.
• Continued research is crucial for the clinical translation of engineered kidneys.