Towards Mesenchymal Stem Cell Therapy in Kidney Transplant Recipients

Abstract

Body homeostasis is maintained by vital organs such as the heart, lungs, kidney and liver. Organ failure due to injury or disease will ultimately result in a life threatening situation. Heart and lung function can be supported and even temporarily replaced by artificial heart and or lung machines. In case of failure of the kidneys, kidney function can partially be replaced by renal replacement therapy in the form of dialysis. In case of failure of many other organs, no replacement therapy is available. The only curative treatment of end stage organ failure is solid organ transplantation (SOT). An organ can either be transplanted from a deceased (post mortal) donor or, in case of living kidney or liver transplantation, from a living donor. If an organ is transplanted from an identical twin, the organ will not be recognized by the recipient’s immune system and will thus be accepted. In any other situation, the transplanted organ (allograft) will be recognized as foreign and will induce alloreactivity resulting in rejection of the organ. Therefore, to maintain their allograft, transplant recipients will in general depend on lifelong use of immunosuppressive medication. Improvements in the immunosuppressive regimen in the last decades have resulted in significant improvements of the short term outcome after transplantation while progress in the long term outcome lagged behind. Nevertheless, immunosuppressive drugs have several unwanted side effects such as the development of diabetes, hypertension, malignancies and nephrotoxicity. In order to optimize long term transplantation outcome, there is a need for new treatment regimens in the field of SOT.