Regeneration and transplantation of the kidney

Abstract

We previously established that mesenchymal stem cells (MSCs) differentiate into functional kidney cells capable of urine and erythropoietin production, indicating that they may be used for kidney regeneration. Recently, we demonstrated the construction of urine excretion pathways in rats and pigs. Rat metanephroi or metanephroi with bladders (developed from cloacas) were transplanted into host rats. Histopathological analysis showed that tubular lumina dilation and interstitial fibrosis were reduced in kidneys developed from cloacal transplants compared with metanephroi transplantation. The host animal's ureter was then connected to the cloacal-developed bladder, a technique we call the "stepwise peristaltic ureter" (SWPU) system. The application of this system avoided hydronephrosis and permitted the cloacas to differentiate well, with cloacal urine being excreted persistently through the recipient ureter. The methods developed here further the research necessary to generate a transplantable kidney.
On the other hand, one group showed that CRISPR-Cas9 multiplexability can be as high as 62, demonstrating the possibility that porcine endogenous retroviruses (PERVs) can be inactivated for clinical application in porcine-to-human xenotransplantation. Another group showed that treatment with the wearable artificial kidney (WAK) was well tolerated and resulted in effective uremic solute clearance and maintenance of electrolyte and fluid homeostasis.
Either xenotransplantation, wearable artificial kidney, or our regenerative method might change dialysis technology and kidney regeneration therapy.