As someone who is currently on dialysis this is obviously very interesting to me. How close are we as a species to actually making a kidney from scratch? When I received my first Kidney Transplant roughly 15 years ago the doctors told me then that we are probably 25 years away from creating a kidney in a laboratory. Recently I have asked the same questions of doctors in the transplant field and they have told me roughly the same number. So how far away are we from actually making a kidney that would be fit for a human?
Making a kidney it turns out is not an easy thing to do. The two small organs that most people have tucked away in the back of their bodies are actually pretty complex. Below is a list of three ways that researchers are currently pursuing in order to try and create this magnificent little organ:
1. Implantable Artificial Kidney
This project is being run by William Fissel from Vanderbilt and Shuvo Roy from the University of California and is under The Kidney Project. The prototype is roughly the size of a coffee cup and uses a combination of silicon nanotechnology and living kidney cells to filter blood. A series of 13 microchips serve as scaffolding for the living cells to grow on and around, creating a bio-hybrid device. So the nanotechnology will perform some of the function of a normal kidney and the living cells will perform other functions of a normal kidney. Its powered naturally with the patient’s own blood flow and at the moment they are working on the fluid dynamics so ensure the device can function without clotting the blood. The first human trials should begin this year.
2. Lab Grown Kidneys
Benjamin D Humphreys is a nephrologist chief of devision of nephrology at the Washington University in St. Louis. He works with Stem-Cell technology and is using this in order to try and make a kidney. The idea is to generate patient-specific stem cells from a patient with kidney failure and then using these cells to generate a kidney in a laboratory and then transplanting this kidney into the patient. Sounds easy right?! There are some hurdles to overcome though. Currently the nephrons that can be grown in a dish is in the hundreds whereas a human kidney contains around 400,000 nephrons. There is also no way to drain the urine that such a kidney would produce so this would require learning how to grow the drainage system – ureters – that could be attached to the patient’s bladder. However conservative estimates for when this could actually be ready are around 15 – 25 years.
Currently the nephrons that can be grown in a dish is in the hundreds whereas a human kidney contains around 400,000 nephrons.
3. Decellularized scaffolds as a platform for bioengineered organs
The ideal here is to take a dead organ, strip it of all its cells so you are just left with a scaffold and then using pluripotent stem-cells, regenerate cells from the patient to build a functioning kidney which you can transplant into them. As you would be using cells from the patient there wouldn’t be any need for the patient to take immunosuppressing drugs once they had received the organ. The idea sounds fantastic but like all of these things there are still some hurdles to overcome. Currently this sort of method has been tested in small animals and the functions exhibited by the bioengineered organs has been rudimentary. Also regenerating the stem-cells to an effective number in the scaffold has yet to be successful. Nice idea but still a ways to go on this one it seems.
Currently this sort of method has been tested in small animals and the functions exhibited by the bioengineered organs has been rudimentary.
So there we have it. Currently it looks like a hybrid artificial kidney will most likely be the first to reach human trials but this solution (although will prevent the need for dialysis) seems to be a stepping stone. Ultimately efforts seem to be on producing a fully functional kidney but this is an extremely complex task. Although massive progress has been made there are still some hurdles to overcome. But do not give up hope! The rate at which technology is evolving is exponential so it will only be a matter of time before a human (or computer) will come up with the solution. Still looks to be a good 15 years away though.