Bioartificial Kidney: Can It End the Need for Dialysis and Immune Suppression?

UCSF researchers advance implantable bioartificial kidneys with silicon nanopore bioreactor, aiming to replace transplant immune suppression and dialysis.

Highlights:

Scientists at UCSF are developing an implantable bioartificial kidney that houses human renal cells within a protective bioreactor
The bioreactor employs silicon nanopore membranes //to shield the renal cells from immune attacks, allowing them to function effectively
This approach aims to replicate kidney functions without the need for immune suppression, potentially revolutionizing kidney failure treatment

Researchers at the University of California San Francisco (UCSF) are developing an innovative approach to treating kidney failure, aiming to eliminate the need for dialysis and immune-suppressing drugs post-transplant.

They conducted a preclinical study that demonstrated the survival of human renal epithelial cells (HRECs) within an implantable bioreactor in pigs. These cells were able to replicate important kidney functions without requiring systemic immune suppression ().

‘More than 500,000 people in the U.S. require dialysis several times a week due to kidney failure, and a Bioartificial Kidney could offer a revolutionary solution to this widespread health challenge. #bioartificialkidney #dialysisnews’

The study is a significant advancement for The Kidney Project, led by Shuvo Roy, PhD, from UCSF, and William H. Fissell, MD, from Vanderbilt University Medical Center. The research focused on establishing the feasibility of a bioreactor component for an implantable bioartificial kidney (iBAK), which employs silicon nanopore membranes (SNPs) to protect the cells from immune rejection.

Bioreactor with Kidney Cells

The ultimate goal is to populate the bioreactor with various kidney cells responsible for essential functions like fluid balance and hormone regulation and combine it with a hemofilter device for blood waste filtration.

The researchers emphasized their commitment to replicating key kidney functions safely. The bioartificial kidney they're developing is anticipated to improve kidney disease treatment, making it more effective, comfortable, and tolerable.

The researchers detailed their progress in a paper titled "Feasibility of an implantable bioreactor for renal cell therapy using silicon nanopore membranes," published in Nature Communications. The study marks a step toward developing an iBAK with a bioreactor component that mimics native renal tubule function. They demonstrated the feasibility of a bioreactor using SNPs to potentially protect against rejection and sustain HRECs both in vitro and in vivo.

Kidney Transplantation
Since the early times, the novel idea of transplanting tissues and other body parts from one organism to the other has captured the imagination of successive generations.

Over two million individuals globally receive treatment for end-stage renal disease (ESRD), a number rising due to diabetes and hypertension rates. While kidney transplantation offers positive outcomes, the shortage of donors and the need for lifelong immunosuppression pose challenges. The Kidney Project aims to address these issues by creating a permanent bioartificial kidney solution.

The team designed a bioreactor that interfaces directly with blood vessels, allowing nutrient and oxygen exchange, similar to a transplanted kidney. The silicon nanopore membranes prevent immune cell attacks on the kidney cells. The researchers utilized proximal tubule cells, which regulate water, for testing. These cells have been successfully used by co-author H. David Humes, MD, to aid dialysis patients.

Hawk-Eyeing the Transplanted Kidney

The team monitored the transplanted kidney cells and recipient animals for a week, observing positive outcomes. The bioreactor prototypes containing SNMs remained functional in pigs without systemic immune suppression. The researchers acknowledged that the design prioritized cell viability over transport or metabolic function. Nonetheless, their findings demonstrated the feasibility of an implantable bioreactor with silicon nanopore membranes for protecting human renal epithelial cells.

Test Your Knowledge on Kidney Transplantation
Kidney transplantation is a surgical procedure done to remove a diseased kidney and replace it with a healthy one from a donor. A person requires one healthy functioning kidney to keep the body functions normal ( ). Once a ...

The researchers plan to conduct month-long animal trials, eventually progressing to human trials. They are confident in their approach, having demonstrated the functionality of the bioreactor without the need for immune-suppressing drugs. The next steps involve expanding cell numbers and implantation durations to establish definitive proof and statistical significance.

In conclusion, the study represents a promising advancement in kidney disease treatment, potentially paving the way for a bioartificial kidney that can replicate essential functions while minimizing the need for immune suppression drugs. In a recent study, a pig kidney made a 32-day mark in a human recipient. All these studies are definitely a stepping stone to finding a permanent solution for patients suffering from kidney diseases.

Kidney Transplanted from a Pig Lasts 32 Days in Human Recipient
Xenotransplantation of Pig Kidneys Performs Well After 32 Days in Humans

Reference:

Can an Artificial Kidney Finally Free Patients from Dialysis? - (https://www.ucsf.edu/news/2023/08/426056/can-artificial-kidney-finally-free-patients-dialysis)

Source-Medindia