Thin Thin Maw, MD, medical director of the USC Kidney Transplant Program, shares innovations that could start saving countless lives within the next few years.
Transplant nephrologist Thin Thin Maw, MD, is the medical director of the USC Kidney Transplant Program, part of the USC Transplant Institute and Keck Medicine of USC.
Thin Thin Maw, MD
More than 90,000 people in the U.S. are waiting for a donated kidney, according to the United Network for Organ Sharing (UNOS). Unfortunately, even with efforts to increase the pool of living kidney donors, there aren’t nearly enough donor kidneys to fill the need. As a result, the average wait time for a deceased kidney transplant in California is 8 to 10 years — and most people can’t wait that long.
As the medical director of the USC Kidney Transplant Program, part of Keck Medicine of USC, I’m fortunate to have visibility of the latest advances happening in the field. The innovations that excite me the most are the ones that will start to help fill the need for donated kidneys within the next 5 to 10 years.
Genetically modified animal kidneys are moving from research to clinical practice.
In 2025, the development of kidney xenotransplantation — transplanting genetically modified pig kidneys into humans — moved into clinical trials. In the past, the genetic differences between pigs and humans would lead to infection and rejection of the pig kidney by the human recipient. In order for pig kidneys to be a reliable and safe organ source for transplantation, finding the precise genetic modifications is necessary.
While xenotransplantation has been in clinical practice for 20 years, finding the correct genetic modification that effectively protects kidney recipients from infection and rejection has been among the most challenging obstacles. However, recent developments have made the procedure safe enough to try on willing human patients. If these trials are successful, we could see xenotransplantation in common use in as little as five years.
Stem cell organoids are pointing the way toward lab-grown kidneys.
An exciting development happening at USC Stem Cell, the department of stem cell biology and regenerative medicine at the Keck School of Medicine of USC, is the development of kidney organoids, which are miniature, 3D models of the human kidney grown from stem cells. At USC Stem Cell’s Li Lab, led by Zhongwei Li, PhD, associate professor of medicine and stem cell biology and regenerative medicine at the Keck School, scientists are applying the principals of stem cell–derived organ growth to create these miniature kidneys.
Developing organoid kidneys has been no small feat. The kidney is a complex organ, with many different types of cells that need to be replicated and grown as one cohesive unit. However, the kidney organoids we have today are advanced enough to mimic the structure and function of the kidneys.
While kidney organoids have already provided much in the way of kidney disease research and prevention, they currently lack the maturation and size required to function inside a human body. However, progress is accelerating, and lab-grown kidneys suitable for transplantation may become a reality within the next 10 to 15 years.
Currently, prevention remains our most powerful tool.
Right now, we have the knowledge and expertise to help patients minimize the risk that they’ll ever need a kidney transplant. Lifestyle education and regular screenings are already doing a lot of this work, but it is my hope that we may soon develop better tools for preventing kidney disease and catching it early, when we can more easily slow its progression.
Currently, the top condition leading to kidney failure is diabetes, so increased education about diabetes prevention, as well as regular patient screenings, would go a long way in reducing the need for kidney transplant each year.
Also, while it would be helpful to be able to catch kidney disease early, many symptoms of early kidney disease are currently easy to pass off as something innocuous. For example, a person with ankle swelling at the end of the day may think they just spent too long sitting at their desk. A person with fatigue could reasonably ascribe their exhaustion to any number of lifestyle factors or common illnesses.
As we look ahead, developing more rigorous screenings, talking more about family history and educating the public may be the most immediate tools we have to reduce kidney transplant wait times by lowering the number of patients who reach kidney failure. In the meantime, each scientific innovation in the field counts as a victory, and every scientific breakthrough — whether in xenotransplantation, stem cell research or disease prevention — brings us one step closer to meeting the urgent need for kidney transplants.
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