Reza Khorramirouz

1. The Optimal Decellularization Protocol for Human-sized Kidney: In Vivo Transplantation
andShort-termFollow-up in a Sheep Model
ABDOL-MOHAMMAD KAJBAFZADEH, REZA KHORRAMIROUZ, ARAM
AKBARZADEH, BEHNAM NABAVIZADEH
Introduction: There have been increased efforts to develop alternative management methods
instead of dialysis and homograft renal transplantation. One of the recent methods includes tissue
engineering to produce a natural scaffold that could help with solving allograft rejection and
obviating the need for immunosuppressive therapy. Complete decellularization of kidney with
intact extracellular matrix (ECM) is the most important factor for further invivo compatibility
and success of transplantation. Herein, we evaluate the efficacy of two different decellularization
protocols in this regard.
Materials and methods: Ten whole sheepkidneys were decellularized by perfusion based
method utilizing two different protocols (Protocol 1: SDS 1% only Vs. Protocol 2:triton 1% and
SDS 0.5%).The samples were evaluated by histopathology in terms of decellularization and
ECM preservation. CT angiography was performed to evaluate vasculature. Subsequently, both
methods were transplanted and evaluated in four sheep and monitored for vascular integrity and
extravasations in short-term.The explanted kidneys were evaluated by histopathology.
Results:Both samples were decellularized completely but the ECM showed different patterns.
After transplantation, the samples treated with protocol 1 showed extravasation of fluid in the
interstitial space while the samples treated withprotocol 2 showed intact ECM andvasculature.
Bothsheep in protocol 1 expired in first postoperative day due to massive extravasation, but
inprotocol 2 allsheep were monitored for evidence of extravasation for 3 days and then explanted
with no notable fluid accumulation.

2. Conclusion:Our study demonstrated the efficacy of well-preserved ECM in better structure
formation and excellent renal vascular perfusion of decellularized kidney transplantation.