The bioartificial kidney

Buffington, Deborah A.; Westover, Angela J.; Johnston, Kimberly A.; Humes, H. David

doi:10.1016/j.trsl.2013.10.006

Cited by 24 publications

(21 citation statements)

References 51 publications

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“…This addition of renal tubule cell therapy to CVVH treatment improved day 28 mortality (RAD vs. conventional CRRT, 33% vs. 61%) and was associated with more rapid recovery of kidney function in ICU patients with AKI in the randomized, multicenter trial [2]. Moreover, this bioengineered bioartificial device using renal tubule cells showed metabolic activity and influenced systemic leukocyte activation and the balance of inflammatory cytokines, suggesting the bioengineered device may be beneficial to patients with acute kidney injury and multiorgan failure [3]. Stem cells play significant roles in kidney repair in various pathological conditions.…”

Section: Bioartificial Kidney Using Renal Tubule Cellsmentioning

confidence: 95%

“…Stem cells have a capacity of self-renewal and can divide to specialized and differentiated cell types. There are so many obstacles for commercial use of stem cells toward clinical application [3]. For example, bioengineered cell system should be capable of passing the various regulatory testing and suitable for mass production.…”

Section: Bioartificial Kidney Using Renal Tubule Cellsmentioning

confidence: 99%

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Current status of bioartificial kidney

Shin¹

2014

JBiSE

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Current dialysis systems are not perfect considering the low efficacy and cumbersome process of actual practice. To overcome these shortcomings, bioartificial kidneys using renal tubule cells and wearable dialysis are promising ESRD treatments available in the near future. Toward clinical application, however, there are so many obstacles for commercial use of them. In this review, current status of bioartificial kidneys such as the renal tubule cell assist device (RAD) and wearable dialysis devices is presented with the comparison to show the advantages and disadvantages.

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Section: Bioartificial Kidney Using Renal Tubule Cellsmentioning

confidence: 95%

Section: Bioartificial Kidney Using Renal Tubule Cellsmentioning

confidence: 99%

Current status of bioartificial kidney

Shin¹

2014

JBiSE

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“…The BRECS, consisting of niobium‐plated trabeculated carbon disks (CY‐908, Cytomatrix, Belmont, Victoria, Australia) colonized with 2 × 10 8 human renal epithelial cells (RECs), has been bio‐engineered to allow for adherence to current Good Manufacturing Practice (cGMP) guidelines, through seeding, perfusion, cryopreservation for storage and distribution, and thaw, for on‐demand use (Buffington et al, ). The BRECS design evolved from a larger, block‐style housing, culminating in a mass‐produced, injection‐moulded (IM) design that was fitted with monitoring systems and temperature probes, allowing for the real‐time monitoring of oxygen consumption (Buffington et al, ). The BRECS is roughly 8.5 cm × 8.5 cm × 1.5 cm, with a fill volume of 10 ml.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to glomerular filtration, the kidney's roles of endocrine, metabolic and excretory function are becoming more accepted as essential to homeostasis. A less recognized role of the kidney, particularly renal tubule cells, is immunoregulatory function (Buffington et al, ). In the acute situation, early intervention with renal cell therapy in sepsis may have therapeutic benefit by replacing cell function lost by tubule injury occurring early in the septic cascade.…”

Section: Introductionmentioning

confidence: 99%

A bio‐artificial renal epithelial cell system conveys survival advantage in a porcine model of septic shock

Westover

Buffington

Johnston

et al. 2014

J Tissue Eng Regen Med

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Renal cell therapy using the hollow fiber based renal assist device (RAD) improved survival time in an animal model of septic shock (SS) through the amelioration of cardiac and vascular dysfunction. Safety and ability of the RAD to improve clinical outcomes was demonstrated in a Phase II clinical trial, in which patients had high prevalence of sepsis. Even with these promising results, clinical delivery of cell therapy is hampered by manufacturing hurdles, including cell sourcing, large-scale device manufacture, storage and delivery. To address these limitations, the bioartificial renal epithelial cell system (BRECS) was developed. The BRECS contains human renal tubule epithelial cells derived from adult progenitor cells using enhanced propagation techniques. Cells were seeded onto trabeculated disks of niobium-coated carbon, held within cryopreservable, perfusable, injection-molded polycarbonate housing. The study objective was to evaluate the BRECS in a porcine model of SS to establish conservation of efficacy after necessary cell sourcing and design modifications; a pre-clinical requirement to move back into clinical trials. SS was incited by peritoneal injection of E. coli simultaneous to insertion of BRECS (n=10) or control (n=15), into the ultrafiltrate biofeedback component of an extracorporeal circuit. Comparable to RAD, prolonged survival of the BRECS cohort was conveyed through stabilization of cardiac output and vascular leak. In conclusion, the demonstration of conserved efficacy with BRECS therapy in a porcine SS model represents a crucial step toward returning renal cell therapy to the clinical setting, initially targeting ICU patients with acute kidney injury requiring continuous renal replacement therapy.

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“…Moreover, on the one hand, HFs have to act as an immunoisolation barrier, but on the other hand, they have to allow mass exchange between the fluid and the cell phase. Hence, the pore size of the HF membranes must be small enough to isolate the embedded exogenous cells but sufficiently large to allow appropriate mass transfer of nutrients to cells and removal of waste metabolites (23,(31)(32)(33)(34).…”

Section: Bioartificial Organsmentioning

confidence: 99%

Hollow Fiber Bioreactor Technology for Tissue Engineering Applications

et al. 2016

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Hollow fiber bioreactors are the focus of scientific research aiming to mimic physiological vascular networks and engineer organs and tissues in vitro. The reason for this lies in the interesting features of this bioreactor type, including excellent mass transport properties. Indeed, hollow fiber bioreactors allow limitations to be overcome in nutrient transport by diffusion, which is often an obstacle to engineer sizable constructs in vitro. This work reviews the existing literature relevant to hollow fiber bioreactors in organ and tissue engineering applications. To this purpose, we first classify the hollow fiber bioreactors into 2 categories: cylindrical and rectangular. For each category, we summarize their main applications both at the tissue and at the organ level, focusing on experimental models and computational studies as predictive tools for designing innovative, dynamic culture systems. Finally, we discuss future perspectives on hollow fiber bioreactors as in vitro models for tissue and organ engineering applications.

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The bioartificial kidney

Cited by 24 publications

References 51 publications

Current status of bioartificial kidney

Current status of bioartificial kidney

A bio‐artificial renal epithelial cell system conveys survival advantage in a porcine model of septic shock

Hollow Fiber Bioreactor Technology for Tissue Engineering Applications

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