Kidney decellularization and recellularization: human kidney cells in a decellularized matrix

Abstract

Chronic kidney disease is a worldwide growing problem. The National Kidney Foundation (NKF) estimates that the number of chronic diseased patients will double in the next 10 years. Total Medicare expenditures on patients with end stage of chronic disease (ESRD) exceeds $17 billion in the United States alone.The kidney has the ability for nearly complete regenerate after ischemia/reperfusion or toxic injury. However, in some injuries the kidney undergoes epithelial-mesenchymal transition and fibrosis with loss of function. Although dialysis and renal transplantation are used to treat ESRD, there is a need to retard development of renal insufficiency or even to block the disease progression. Bioengineering and cell therapy are the main fields of investigation in renal regeneration with the use of stem cell cultures on tridimensional matrixes, an ideal solution for the scarcity of organs for renal transplantation. In this sense, this cellular matrix could provide an ideal solution for the scarcity of kidneys available for transplantation. Recreating a functional kidney that can be incorporated in vivo with minimum immunogenicity is a serious difficulty, exacerbated by the complexity of its tridimensional structure and the multiplicity of cell types. With these concerns, this project aims to comply with the enormous demand fo new treatments for chronic kidney disfunctions with the development of innovative strategies of tissue engineering, based on in vitro culture of human primary renal cells in different enviorments, such as bi-dimensional culture, three dimensional culture and porcine matrix.