THE BIOARTIFICIAL RENAL TUBULE ASSIST DEVICE TO ENHANCE CRRT IN ACUTE-RENAL-FAILURE

Current therapy for acute tubular necrosis (ATN) continues to have an exceedingly high mortality rate, exceeding 50% even with dialytic or h emofiltrative support, Current renal replacement therapy in ATN only s ubstitutes for filtration function of the kidney but not its cellular metabolic functions, Replacing these metabolic functions may optimize current therapy for this devastating disease process, In this regard, a renal tubule assist device (RAD) has been developed to be placed in an extracorporeal continuous hemoperfusion circuit in series with a he mofilter, The RAB consists of porcine renal proximal tubule cells grow n as confluent monolayers of a multifiber bioreactor with a membrane s urface area from 0.4 to 1.6 m(2). The cells along the inner surface of the hollow fibers are immunoprotected from the patient's blood by the hollow fiber membrane, In preliminary experiments in uremic dogs, thi s device has been shown to tolerate a uremic environment while providi ng reabsorptive, metabolic, and endocrinologic activity, Pilot human t rials of the RED are anticipated within the next year to improve curre nt renal replacement therapy in ATN. (C) 1997 by the National Kidney F oundation, Inc.