Making new kidneys: On the road from science fiction to science fact.
OBJECTIVE
Allogenic kidney transplantation use is limited because of a shortage of kidney organ donors and the risks associated with a long-term immunosuppression. An emerging treatment prospect is autologous transplants of ex vivo produced human kidneys. Here we will review the research advances in this area.


RESULTS
The creation of human induced pluripotent cells (iPSCs) from somatic cells and the emergence of several differentiation protocols that are able to convert iPSCs cells into self-organizing kidney organoids are two large steps toward assembling a human kidney in vitro. Several groups have successfully generated urine-producing kidney organoids upon transplantation in a mouse host. Additional advances in culturing nephron progenitors in vitro may provide another source for kidney engineering, and the emergence of genome editing technology will facilitate correction of congenital mutations.


CONCLUSIONS
Basic research into the development of metanephric kidneys and iPSC differentiation protocols, the therapeutic use of iPSCs, along with emergence of new technologies such as CRISPR/Cas9 genome editing have accelerated a trend that may prove transformative in the treatment of ESRD and congenital kidney disorders.
aDivision of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA bDivision of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Oded
O
Volovelsky
Raphael
R
Kopan
D000818:Animals; D002454:Cell Differentiation; D006801:Humans; D057026:Induced Pluripotent Stem Cells / Q000166:cytology / Q000502:physiology; D007668:Kidney / Q000166:cytology / Q000502:physiology; D016030:Kidney Transplantation; D051379:Mice; D009940:Organoids / Q000166:cytology / Q000502:physiology; D023822:Tissue Engineering; D014182:Transplantation, Autologous