Bioengineering kidneys for transplantation

Abstract

One in 10 Americans suffers from chronic kidney disease, and close to 90,000 people die each year from causes related to kidney failure. Patients with end-stage renal disease are faced with two options: hemodialysis or transplantation. Unfortunately, the transplantation option is limited because of the shortage of donor organs and the need for immunosuppression. Bioengineered kidney grafts theoretically present a novel solution to both problems. Herein, we discuss the history of bioengineering organs, the current status of bioengineered kidneys, considerations for the future of the field, and challenges to clinical translation. We hope that by integrating principles of tissue engineering, and stem cell and developmental biology, bioengineered kidney grafts will advance the field of regenerative medicine while meeting a critical clinical need.

Keywords: Kidney; bioengineering; organ engineering; perfusion decellularization; transplantation.

Figure 1. Current strategies for engineering a bioartificial kidney for transplantation

Current strategies to create a bioarticial kidney can be divided into three stages: (1) generating a scaffold by bioprinting or decellularization; (2) populating the scaffold with cells from embryonic stem cells or induced pluripotent stem cells; (3) maturing the organ in vitro or in vivo. After the kidney has been matured, it can be transplanted into humans.