Equipment set-up for perfusion decellularization of whole kidney Decellularized Kidney: A New Boost towards the Development of Bioartificial Transplantable Humanized Organ Sandeep Kumar Vishwakarma1, Avinash Bardia1, P. Ganga Bhavani1, Nusrath Fathima1, Parveen N1, Mohd. Ishaq1, J. Venkateshwarulu2, Aleem Ahmed Khan1 1 Salar-E-Millat Sultan Salahuddin Owaisi Centre for Cellular and Molecular Medicine, 2 Department of Radiology, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, 500 058, Andhra Pradesh, INDIA. aleem_a_khan@rediffmail.com Introduction Transplantation remains the only available curative treatment for patients with end stage renal diseases however, hemodialysis has increased the survival rate little longer. Stagnant donor organ (Kidney) numbers have increased waiting times to over 3 years and waitlist mortality to 5–10%. Despite advances in renal transplant immunology, 20% of recipients experience an episode of acute rejection within 5 years of transplantation, and approximately 40% of recipients die or lose graft function within 10 years after transplantation. Creation of a bioengineered kidney could theoretically bypass these problems by providing an autologous graft on demand. Technology of removing cells and its components from the organ followed by repopulation of cells within the organ scaffold is termed as Decellularization and Recellularization. This technology produces 3-D architecture and vascular tree which provides inducing factors for the engraftment, proliferation and survival of the cells. Advantages of decellularized organs Solves the problem for life long use of immunosuppressant after organ transplant. Reduces the risk of rejection. Provides important signal for the engraftment, survival and function of transplanted cells in new borne organ. Allows rapid delivery of oxygen and nutrients after recellularization and reconnection to the circulation. Materials and methods Perfusion decellularization of rat kidneys were performed in accordance with Animal Welfare Act and approved by institutional ethics committee. Kidney was retrieved from rat abdomen after systemic heparinization and transection of renal artery, vein and ureter. Kidney decellularization was performed through renal artery using a combination of SDS and Triton-X-100 at 30mm Hg pressure. Vascular integrity of whole decellularized kidney was checked by contrast imaging (angiogram). Further the decellularized Kidney bioscaffold was characterized to ensure complete removal of cells retaining the complete vascular architecture and connective tissues as scaffold. Results The decellularized Kidney vascular network was able to withstand fluid flow that entered through a central inlet vessel, branched into an extensive capillary bed, and coalesced into a single outlet vessel. Kidney capsule was found to be intact after decellularization . Extracellular matrix and vascular network within the decellularized kidney was retained intact without damage. Major challenges Refinement of treatments to preserve the ECM Appropriate 3-D spatial organization of cells Innervations Generation of Lymphatic system Maintenance of vascular network Product standards that assess all scaffold criteria Optimization of experiments for system of interest Standardized lab animal testing and quality standard Differences in specimens, agents and protocols Post-transplantation analysis Equipment set-up for perfusion decellularization of whole kidney Conclusion The study has demonstrated a potential approach for the development of natural whole Kidney scaffold in the fabrication of kidney tissues and whole organ support to provide a resource for the treatment of end stage renal diseases.