Kidney tissue engineering in preclinical models of renal failure: a systematic review and meta-analysis

Plain language summary Organ transplantation is limited by donor organ shortage throughout the world. Tissue engineering involves the use of biocompatible scaffold upon which cells can grow into functional tissues. Researchers have already experimented with kidney tissue engineering on several animal models. In this research, we systematically looked for all available studies in literature to collate and contrast the results of such studies. We found 19 relevant articles involving 937 animals. We learned that, in general, the use of biomaterial combinations, addition of specific biomolecules, and seeding of cells on scaffolds were associated with more favorable results. Quantitative analysis of several markers supported these conclusions. Despite advances in the field, kidney tissue engineering is still at its infancy, and more controlled animal experiments on more novel biomaterial are needed before we could translate this technique to humans. Aim: This study aims to compare the efficacy of tissue engineering for kidney reconstruction. Materials & methods: We searched MEDLINE, EMBASE (May 2021), and reference lists of review articles. Results: 19 articles matched our inclusion criteria. A range of natural, synthetic and hybrid scaffolds with or without incorporating cells/growth factors was investigated in 937 animals. More favorable results were observed with a combination of two or more biomaterials, addition of bioactive moieties, and cell seeding. Creatinine concentration, PAX2, collagen type-1, alpha-SMA, vimentin, IL-1, IL-6 and TNF-alpha gene expressions were significantly increased compared with native control. Conclusion: Tissue engineering can improve renal function and regeneration; however, further research could benefit from using hybrid scaffolds, stem cells and large animal models.