How did you become interested in kidney disease?
My uncle was diagnosed with kidney disease when he was 28 years old. By the time I was finishing my Ph.D., his first kidney transplant had already failed, and he was on dialysis. The life expectancy for most people on dialysis is about five years. I realized there was no stem cell therapy for kidney disease, so I devoted the next five years to figuring out how to generate new kidney cells, starting with a patient’s own cells. That was the genesis of my lab.
Tell us about kidney organoids.
When you’re able to get the right stem cells to turn into the right kidney cells, you end up forming these really beautiful kidney structures in a dish — what we call organoids. In 2015, for the first time, we were able to generate kidney organoid structures in a dish. Since then, they’ve started to shed light on how different types of kidney disease arise. We’re also learning how the kidneys grow inside the womb, which allows us to grow better kidney structures. The ultimate hope is that we’ll be able to grow fully immune-compatible kidney tissue on demand for anyone who needs it.
What do you find most exciting about your research right now?
We’ve started using liquid-handling robots that can make these organoids in large quantities in a highly reproducible way. They can perform hundreds, perhaps thousands, of experiments at a time and study the effects of thousands of different drugs on the organoids’ development or disease symptoms. When you combine that with emerging technologies like artificial intelligence, photo recognition and robotic analysis methods, it’s been a very exciting time for my research.
How is your uncle?
He’s doing well. Eight years ago, he received a second transplant. Still, there’s no such thing as a perfect organ transplant, not really — even “perfect” matches are slowly but steadily being rejected by the body. So my uncle has been on immunosuppressive drugs since he was 28 years old. Over time, they have deleterious effects.
Will your work help him?
Would it be possible to deliver something like an artificial kidney to my uncle (or a patient like my uncle) in a clinical study by the time he needs his next transplant? Well, we need to do a lot more work. It’s all a matter of how the field progresses and how much investment there is from stakeholders to really move these technologies forward. But I think it’s conceivable.
Dr. Freedman is a UW Medicine researcher in the Division of Nephrology and the Institute for Stem Cell and Regenerative Medicine, as well as a member of the Kidney Research Institute (a collaboration between Northwest Kidney Centers and UW Medicine).