Hello, readers! It’s good to be back. As you know, the Kidney Lover adores kidneys. And when she finds a story that combines kidneys and creative thinking, then a-blogging she must go.

You may have read our recent research blog about bioengineered rat kidneys. Scientists at Massachusetts General Hospital begin this innovative process by stripping rat kidneys of their existing cells, creating a scaffold for new tissue to grow.

Wake Forest Baptist Medical Center researchers have taken this scaffold concept one step further, suggesting that we could do the same thing with organs deemed unsuitable for transplant. Right now, doctors must reject almost 20% of deceased donor kidneys because they are diseased or because they have gone too long without oxygen or blood flow.

I must say, I love this idea from Wake Forest. (Be sure to read more about it here.) It is clever and resourceful. It promotes organ donation and honors the wishes of those who wouldn’t be able to donate after death ordinarily, and it would certainly mean a shorter wait time for those in need of a kidney.

The science of growing kidneys will, of course, take time to develop and perfect. Until then, we can be glad that researchers are looking for more and more ways to prevent kidney disease from happening in the first place. And we can take heart in good news from the organ donation front. According to a national Mayo Clinic poll, nearly 50% of Americans would consider donating a kidney to a stranger and 84% would consider donating to a family member or friend. In the U.K., the number of people donating their organs after death has gone up 50% in the last five years. Living kidney donations to strangers in the U.K. have almost tripled in the last year.

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Let’s wipe out kidney disease together!

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Previously stripped-down rat kidney newly filled with endothelial cells

Researchers from Massachusetts General Hospital have succeeded in growing bioengineered kidneys in the lab and implanting them into rats. To create the functioning organs, they began by using a detergent solution to strip rat kidneys of their existing cells. This resulted in a collagen scaffold, where a variety of cell types were delicately introduced to the appropriate areas within the kidney structure, and allowed to grow in conditions simulating that of a living body. The mature kidneys were then transplanted into rats, where they began producing urine right after implantation. Though they did not perform as well as healthy kidneys, the researchers believe that one day, this technique could be used to regenerate human kidneys, using a patient’s own cells and avoiding the need for harmful immunosuppressant drugs.

Photo credit: Massachusetts General Hospital Center for Regenerative Medicine

Sources:

Implantable, Bioengineered Rat Kidney: Transplanted Organ Produces Urine, but Further Refinement is Needed, ScienceDaily, April 14, 2013

Video of Lab-Grown Functional Kidney Amazes, Renal Business Today, Kasia Michalik, April 17, 2013

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Transplant Recipients International Organization (TRIO) Ventury County West Valley Chapter is hosting a free seminar open to all transplant recipients/candidates, dialysis patients waiting for a transplant, medical professionals and family members on Saturday, March 16, 2013 from 9 a.m. to 11 a.m at the Calabasas Tennis and Swim Center located at 23400 Park Sorrento in Calabasas, CA 91302. A continental breakfast will be served.

Anjay Rastogi, M.D., Ph.D., Department of Medicine, Division of Nephrology at the David Geffen School of Medicine UCLA will present “Blood Pressure: What You Can Do to Improve Outcomes.” About 1 in 5 U.S. adults with high blood pressure don’t know that they have it. Less than half of the people with high blood pressure (46%) have their condition under control. High blood pressure is a major risk factor for kidney disease.

Reservations are required and seating is limited to 65 attendees. If you would like to attend the seminar, please reserve your spot by contacting TRIO President, Ron Taubman at (818) 309-7919 or email him at taubmanappr@dslextreme.com.

Download the pdf file for this event.

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Dr. Vito Campese, Rep Adam Schiff, Alicia McDonough, Ph.D. and UKRO President, Ken Kleinberg

Yesterday UKRO President, Ken Kleinberg, Vito Campese, M.D., Chief of Nephrology of the Keck School of Medicine of USC, and kidney researcher Alicia McDonough, Ph.D., met with Representative Adam Schiff to ask for his help in preventing sequestration cuts that would severely limit NIH funding for research. Speaking on behalf of UKRO and the USC/UKRO Kidney Research Center,  Dr. Campese stressed that research is essential to new medical advances that will drive down the skyrocketing cost of healthcare. He pointed out the high cost of the burgeoning epidemic of kidney diseases and hypertension.  Kidney disease consumes nearly 7% of Medicare costs and 27.6% of Medicare expenditures. Approximately 26 million Americans have kidney disease and that number is expected to increase. Today there are more than 95,000 people in need of a kidney transplant and the average wait for a kidney is 8 years. There simply aren’t enough kidneys for everyone. Research provides the best hope for life-saving medical advances for these patients. Congressman Schiff brought up the fact that even if a patient is lucky enough to receive a transplant, Medicare funding for anti-rejection drugs runs out three years after transplant. Such a patient could end up back on dialysis—a tragedy not only in human, but economic terms; caring for a dialysis patient is far more expensive than caring for a transplant patient.

Ken Kleinberg shared the story of his FSGS diagnosis, subsequent kidney failure and years spent on dialysis. He acknowledged that he is alive and healthy today because of improved treatments, procedures and medications derived from decades of medical research, but even so, there is still so much more scientists need to learn about diseases like FSGS. Without NIH funding for research, important scientific work will cease.

Dr. McDonough spoke on behalf of the American Society of Nephrology, which represents 14,000 physicians, scientists and other healthcare professionals dedicated to curing kidney disease. Even currently, before the potential cuts, funding has dried up at the NIDDK for both small start-up grants and big program grants that usually help new junior investigators set up their labs. Only 10% of the individual research grant applications are funded overall, so it is very difficult for new investigators in the pipeline to compete. Some researchers have decided to go to Singapore to work.

Representative Schiff was responsive, commenting that he agrees with President Obama on the importance of funding research to improve the economy and that not doing so is, “eating our seed corn.” Everyone agreed that support for research and the importance of innovation, production, and progress has always been a part of the American ethos and it must be maintained. NIH funding must be protected. It generates jobs, stimulates the economy and ultimately helps save American lives.

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UC San Francisco and Emory University researchers analyzing data from 2005 to 2009, have found that race and insurance are major factors in assessment for kidney transplantation. They discovered that young black patients (less than 35 years of age) and patients without private health insurance were less likely to be assessed as candidates for kidney transplantation upon starting dialysis. They were also less likely to be put on the transplant waiting list and less likely to receive a kidney transplant.

These findings are significant, given a recent Johns Hopkins study that revealed that younger African American dialysis patients aged 18 to 30 are twice as likely to die as white patients. According to Rachel Patzer, PhD, a researcher at Emory University School of Medicine, “Disparities in the assessment of patients for transplant could be reduced with interventions designed to encourage providers to assess patients as early as possible in the course of late-stage chronic kidney disease and diagnosis of kidney failure.”

Source:

Race and Insurance a Big Factor in Being Assessed for Kidney Transplantation, Red Orbit, July 27, 2012

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Our spokesperson, Valen Keefer, continues to inspire the kidney disease and transplant community with her new blog for the PKD Foundation, PKD Will Not Beat Me. She’ll be sharing her story and fostering a positive space where people with PKD can come together to talk with each other, get information and lift each other’s spirits.

We are so proud of Valen and the wonderful work she does! Check out her first blog post and you’ll find out what PKD really stands for in Valen’s world.

A screen shot of Valen's blog

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Researchers from Indiana University School of Medicine have shown that renal stem cell transplants may have the potential to repair damaged kidneys. In the study using rats with acute kidney injury and CKD, the scientists reprogrammed adult kidney cells to express the SAA gene, thus producing the SAA protein, which is essential to early kidney development as well as repair after acute injury. The reprogrammed cells were able to travel to damaged areas of the kidney, successfully integrate themselves and regenerate tissue, improving kidney function and reducing inflammation and fibrosis. Some of the rats were treated with donor stem cells, while others were treated with their own cells. Testing such a procedure in humans is a long way off, but the results of the study are encouraging. Researcher Katherine J. Kelly, M.D. said, “Ultimately, you can imagine taking a part of someone’s kidney, expanding those cells with appropriate growth factors in a tissue culture dish, and then giving the cells back.”

Sources:

Intravenous Kidney Cell Transplant Experiments Raise Hope for Future Human Kidney Failure Treatments, Science Daily, May 31, 2012

Intravenous Renal Cell Transplantation (IRCT) for Rats with Acute and Chronic Renal Failure, American Journal of Physiology, Renal Physiology, May 11, 2012

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Scientists from Kidney Research UK have discovered a way to increase the success of kidney transplants from deceased donors by reviving the kidneys prior to transplantation using normothermic perfusion. Blood flow is reintroduced to the kidney via a special machine, effectively reversing the damage caused by storing the kidney on ice. The scientists believe kidneys treated with normothermic perfusion will perform sooner after transplantation, work better and last longer, with less likelihood of rejection.

This new treatment could increase the number of organs available from deceased donors. “Marginal” organs from donors with diabetes or hypertension or from donors who have suffered cardiac arrest are typically discarded, but this could change if the scientists are able to successfully revive such kidneys and assess their future performance prior to transplantation.

Source:

Revolutionary New Kidney Transplant Procedure, Medical News Today, March 8, 2012

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In an ongoing study, Northwestern Medicine and University of Louisville researchers have shown that it may be possible to eliminate the need for rejection drugs in kidney transplantation. The scientists paired living kidney donors with unrelated recipients with compatible blood type and a negative crossmatch. The kidney patients underwent radiation and chemotherapy treatments to prepare their bodies to receive specially processed bone marrow stem cells from their donors. Ideally, the stem cells grow in the patient’s marrow, creating a second bone marrow system. Patients received these stem cells one day after kidney transplantation and were eventually weaned off anti-rejection drugs after one year. Early results of the study are promising. The researchers hope that patients who are currently experiencing success will be able to stay off immunosuppressant drugs long-term. They plan to conduct a second study using patients with existing kidney transplants from living donors.

Source:

New Transplant Method May Allow Kidney Recipients to Live Life Free of Anti-Rejection Medication, Science Daily, March 11, 2012

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A team of researchers from University of Miami Miller School of Medicine and Xiamen University in China have shown that a combination of mesenchymal stem cell therapy and immune suppressing calcineurin inhibitors (CNIs) produces better short-term transplant outcomes than standard anti-rejection drugs and CNIs. Patients who received a transplant from a living relative were treated with their own mesenchymal stem cells or MSCs, which act as natural immune cell suppressors. Six months after transplant, they experienced fewer acute rejections and better kidney function and had lower risk of infections. They also recovered faster from acute rejection. After one year, survival and rejection rates were comparable with patients who had received the standard induction therapy. Though the benefits of the stem cell therapy appear to have been short-lived, the researchers view the results as a step forward. Dr. Robert Provenzano, Chair of the Department of Nephrology, Hypertension, and Transplantation at St. John Providence Health System said, “I see this as the continued evolution of transplant medicine. It’s very exciting to be able to use your own natural cells instead of more toxic medications.”

Source:

Stem Cell Therapy Could Boost Kidney Transplant Success: Study, Health Day, March 20, 2012

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