Authors: (Matthew L. Holzner, Nandita Singh, and Ron Shapiro)
Abstract: The demand for renal transplantation has greatly outpaced the available supply of
organs. Despite efforts to increase the donor pool, wait lists continue to grow.
Bioengineering and xenotransplantation offer unique solutions to the organ shortage.
Based on decellularization-recellularization technology, whole organ bioengineering aims
to create an unlimited supply of organs by repopulating biocompatible scaffolds with
functional parenchyma. Xenotransplantation also has the potential to provide an
inexhaustible source of organs and has recently achieved significant long-term survival pig
to non-human primate models. Here, we review these evolving approaches to renal
transplantation. We describe the process of tissue engineering including potential sources
of autologous cells for reseeding. We also discuss the immunological barriers, and
strategies to overcome them, facing xenotransplantation. We believe these approaches will
play an important role in the future of renal transplantation.