The opportunity of stem cells application in kidney transplantation: clinical studies (review)

Kidney transplantation remains the optimal method of end-stage renal disease treatment, but the result of such ope­rations depends on the immune response of the recipient to the transplanted organ. Side effects of modern immunosuppressive drugs, such as nephrotoxicity, opportunistic infection, and increased risk of cancer, negatively affect the long-term results of transplantation. In recent years, studies of the properties and uses of stem cells have aroused considerable interest and expectations. The biological characteristics of stem cells, inclu­ding multi-row differentiation, self-guidance, paracrine effects, immunomodulation, ability to suppress the immune response against graft, have opened new horizons for their use in kidney transplantation, but according to different studies, the safety and effectiveness of stem cells clinical use remain controversial. The use of stem cells in animal models with renal failure shows better results in the postoperative period and provides an opportunity for clinical research in the context of creating alternative induction therapy in kidney transplantation. The preclinical efficiency of stem cells in the chronic renal failure model and renal allotransplantation in laboratory animals showed their unique potential to improve function and repair the damaged kidney. They also demonstrate immunosuppressive effects that realize in the inhibition of T-cell proliferation and dendritic cells maturation, the induction of Т-regulatory cells, which can improve the long-term results of kidney allotransplantation. This review summarizes the results of previous studies and is aimed to provide an objective point of view based on a comprehensive analysis of currently known advantages and disadvantages of stem cell therapy in kidney transplantation and highlights aspects that require further research.