TED2009
Daniel Kraft: A better way to harvest bone marrow
Daniel Kraft vynašiel lepší spôsob odoberania kostnej drene
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Daniel Kraft predvádza Marrow Miner - nový prístroj, ktorý rýchlo odoberá život zachraňujúcu kostnú dreň s minimálnou bolesťou pre darcu. Zdôrazňuje, že dospelé kmeňové bunky, ktoré sa nachádzajú v kostnej dreni, môžu byť použité na liečbu mnohých smrteľných ochorení, od Parkinsonovej choroby až po choroby srdca.
Daniel Kraft - Physician scientist
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
Daniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine. Full bio
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00:18
So I am a pediatric cancer doctor
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Som detský onkologický lekár
00:21
and stem-cell researcher at Stanford University
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a zároveň aj výskumný pracovník kmeňových buniek na Stanfordskej univerzite,
00:25
where my clinical focus has been bone marrow transplantation.
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kde je mojím klinickým zameraním transplantácia kostnej drene.
00:28
Now, inspired by Jill Bolte Taylor last year,
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Inšpirovaný minuloročným prejavom Jilla Bolte Taylora,
00:30
I didn't bring a human brain,
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nepriniesol som ľudský mozog,
00:32
but I did bring a liter of bone marrow.
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ale liter kostnej drene.
00:35
And bone marrow is actually what we use
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A kostná dreň je vlastne to, čo používame
00:38
to save the lives of tens of thousands of patients,
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na záchranu životov desiatok tisíc pacientov,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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z ktorých väčšina má pokročilé štádium nádorového ochorenia ako je leukémia, rakovina lymfatických uzlín
00:43
and some other diseases.
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a niekoľko ďalších chorôb.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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Takže, pred niekoľkými rokmi som spolupracoval na transplantácii na Stanforde.
00:49
I'm in the operating room. We have Bob here,
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Bol som na operačnom sále. Toto je Bob,
00:51
who is a volunteer donor.
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ktorý bol dobrovoľným darcom.
00:53
We're sending his marrow across the country to save the life
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Jeho dreň sme poslali naprieč celou krajinou na záchranu života
00:55
of a child with leukemia.
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dieťaťa s leukémiou.
00:57
So actually how do we harvest this bone marrow?
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Tak ako vlastne odoberáme kostnú dreň?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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No máme tam celý operačný tím, celkovú anestéziu, zdravotné sestry
01:03
and another doctor across from me.
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a ďalšieho lekára oproti mne.
01:05
Bob's on the table, and we take this sort of small needle,
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Bob ležal na stole, a my sme použili túto malú ihlu,
01:07
you know, not too big.
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viete, nie príliš veľkú.
01:09
And the way we do this is we basically
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A spôsob, akým sme dreň odoberali bol, že v podstate
01:11
place this through the soft tissue,
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sme prešli cez toto mäkké tkanivo,
01:13
and kind of punch it into the hard bone,
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a vpichli sme ju do tvrdej kosti,
01:15
into the tuchus -- that's a technical term --
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do tuchusu - to je odborný termín -
01:17
and aspirate about 10 mls of bone marrow out,
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a zakaždým sme injekčnou striekačkou vytiahli
01:21
each time, with a syringe.
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asi 10 ml kostnej drene.
01:23
And hand it off to the nurse. She squirts it into a tin.
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A podali to sestre. Tá to vstriekla do nádoby na to určenej.
01:26
Hands it back to me. And we do that again and again.
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A podala mi striekačku späť. Toto sme opakovali znova a znova.
01:29
About 200 times usually.
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Zvyčajne asi 200-krát.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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A na konci tohto procesu mám boľavú ruku a na dlani mám mozoľ.
01:33
let alone Bob,
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Nieto ešte Bob,
01:35
whose rear end looks something more like this,
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ktorého zadná časť vyzerá ako niečo takéto,
01:37
like Swiss cheese.
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ako švajčiarsky syr.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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Takže som premýšľal, viete, tento postup sa za posledných 40 rokov nezmenil.
01:43
And there is probably a better way to do this.
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A pravdepodobne existuje lepší spôsob, ako to urobiť.
01:45
So I thought of a minimally invasive approach,
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Tak som premýšľal o minimálne invazívnom prístupe.
01:48
and a new device that we call the Marrow Miner.
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A o novom zariadení, ktoré nazývame Marrow Miner.
01:50
This is it.
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Toto je ono.
01:52
And the Marrow Miner, the way it works is shown here.
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A spôsob, akým Marrow Miner funguje, môžete vidieť tu.
01:55
Our standard see-through patient.
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Náš štandardný priehľadný pacient.
01:57
Instead of entering the bone dozens of times,
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Namiesto mnohonásobného vpichovania do kosti,
01:59
we enter just once, into the front of the hip or the back of the hip.
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vpichneme len raz, buď v prednej časti bedrového kĺbu alebo v zadnej.
02:01
And we have a flexible, powered catheter
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A máme flexibilný, poháňaný katéter
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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so špeciálnou slučkovou špičkou, ktorá zostáva vo vnútri krehkej časti drene
02:07
and follows the contours of the hip, as it moves around.
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a svojim pohybom okolo kopíruje obrysy bedra.
02:10
So it enables you to very rapidly aspirate,
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Tak to vám umožní veľmi rýchlo odoberať
02:12
or suck out, rich bone marrow very quickly through one hole.
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alebo vysávať, bohatú kostnú dreň cez jediný otvor.
02:15
We can do multiple passes through that same entry.
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Môžeme urobiť niekoľko vstupov cez tento jediný otvor.
02:17
No robots required.
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Nepotrebujete žiadne roboty.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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A tak, veľmi rýchlo, Bob môže mať len jeden vpich, lokálnu anestéziu,
02:22
and do this harvest as an outpatient.
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a urobiť tento odber ambulantne.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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A urobil som niekoľko prototypov. Mal som malý grant na Stanforde.
02:29
And played around with this a little bit.
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A tak som sa s tým trochu hral.
02:31
And our team members developed this technology.
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Členovia nášho tímu vyvinuli túto technológiu.
02:33
And eventually we got two large animals, and pig studies.
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A konečne máme dve veľké zvieratá a štúdie na prasati.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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A zistili sme, na naše prekvapenie, že sme nielen dostali kostnú dreň von,
02:39
but we got 10 times the stem cell activity
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ale máme 10-krát vyššiu činnosť kmeňových buniek
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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v kostnej dreni vďaka Marrow Miner v porovnaní s bežnými prístrojmi.
02:44
This device was just FDA approved in the last year.
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Toto zariadenie bolo v minulom roku schválené úradom FDA.
02:47
Here is a live patient. You can see it following the flexible curves around.
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Tu je živý pacient. Môžete vidieť, ako to kopíruje tieto flexibilné krivky okolo.
02:50
There will be two passes here, in the same patient, from the same hole.
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Budú tu dva odbery, u toho istého pacienta, z rovnakého otvoru.
02:53
This was done under local anesthesia, as an outpatient.
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Toto bolo robené ambulantne v lokálnej anestéze.
02:55
And we got, again, about three to six times more stem cells
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A opäť sme získali, približne tri až šesťkrát viac kmeňových buniek,
02:58
than the standard approach done on the same patient.
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než štandardným postupom na rovnakom pacientovi.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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Prečo by vás to malo zaujímať? Kostná dreň je veľmi bohatý zdroj dospelých kmeňových buniek.
03:04
You all know about embryonic stem cells.
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Všetci viete o embryonálnych kmeňových bunkách.
03:06
They've got great potential but haven't yet entered clinical trials.
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Majú veľký potenciál, ale ešte sa nepoužívajú v klinických štúdiách.
03:09
Adult stem cells are throughout our body,
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Dospelé kmeňové bunky sa nachádzajú na celom tele,
03:11
including the blood-forming stem cells in our bone marrow,
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vrátane krvotvorných kmeňových buniek v našej kostnej dreni.
03:13
which we've been using as a form of stem-cell therapy
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Tieto používame na bunkovú terapiu
03:15
for over 40 years.
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už viac ako 40 rokov.
03:17
In the last decade there's been an explosion of use
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V poslednom desaťročí zaznamenávame vzostup vo využívaní
03:20
of bone marrow stem cells to treat the patient's other diseases
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kmeňových buniek kostnej drene pri liečbe iných chorôb pacientov,
03:23
such as heart disease, vascular disease,
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ako sú napr. srdcové choroby, cievne ochorenia,
03:25
orthopedics, tissue engineering,
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ortopédia, tkanivové inžinierstvo,
03:27
even in neurology to treat Parkinson's
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a dokonca aj v neurológii na liečbu Parkinsonovej choroby
03:29
and diabetes.
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a cukrovky.
03:31
We've just come out, we're commercializing, this year,
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Práve sme sa dostali na trh, tohto roku medializujeme
03:33
generation 2.0 of the Marrow Miner.
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2. generáciu prístroja Marrow Miner.
03:35
The hope is that this gets more stem cells out,
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Dúfame, že sa týmto prístrojom získa viac kmeňových buniek.
03:37
which translates to better outcomes.
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Čo znamená lepšie výsledky.
03:39
It may encourage more people to sign up to be
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Môže povzbudiť viac ľudí byť potenciálnymi darcami
03:41
potential live-saving bone marrow donors.
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život zachraňujúcej kostnej drene.
03:43
It may even enable you to bank
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Dokonca to môže umožniť uložiť
03:45
your own marrow stem cells, when you're younger and healthier,
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kmeňové bunky vašej kostnej drene, keď ste mladší a zdravší,
03:47
to use in the future should you need it.
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na použitie v budúcnosti v prípade potreby.
03:50
And ultimately -- and here's a picture of our
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A nakoniec - je tu obrázok našich pacientov,
03:52
bone marrow transplant survivors,
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ktorí prežili vďaka transplantácii kostnej drene,
03:54
who come together for a reunion each year at Stanford.
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ktorí sa spolu každoročne stretávajú na Stanforde.
03:56
Hopefully this technology will let us
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Dúfajme, že táto technológia nám umožní
03:58
have more of these survivors in the future.
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mať v budúcnosti viac takýchto pacientov, ktorí prežijú.
04:00
Thanks.
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Ďakujem.
04:02
(Applause)
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(Potlesk)
ABOUT THE SPEAKER
Daniel Kraft - Physician scientistDaniel Kraft is a physician-scientist, inventor and entrepreneur. He is the founder and chair of Exponential Medicine and has served as faculty chair for Medicine at Singularity University since its inception, exploring the impact and potential of rapidly developing technologies as applied to health and medicine.
Why you should listen
Dr. Daniel Kraft is a Stanford and Harvard trained physician-scientist with more than 25 years of experience in clinical practice, biomedical research and innovation. He is Faculty Chair for Medicine at Singularity University and is the founder and chair for Exponential Medicine, a program which explores convergent, rapidly developing technologies and their potential to reshape the future of health and biomedicine.
After medical school at Stanford, Kraft was board certified in both Internal Medicine and Pediatrics following residency at the Massachusetts General Hospital & Boston Children's Hospital, and he completed Stanford fellowships in hematology/oncology & bone marrow transplantation. He is a member of the inaugural class of Aspen Institute Health Innovators Fellows.
Kraft has extensive research in stem cell biology and regenerative medicine with multiple scientific publications, medical device, immunology and stem cell-related patents through faculty positions with Stanford University School of Medicine and as clinical faculty for the pediatric bone marrow transplantation service at University of California San Francisco.
Kraft recently founded IntelliMedicine, focused on connected, data-driven and integrated personalized medicine. He is the inventor of the MarrowMiner, an FDA-approved device for the minimally invasive harvest of bone marrow, and he founded RegenMed Systems, a company developing technologies to enable adult stem cell-based regenerative therapies. He is an advisor the XPRIZE (having conceived of the Medical Tricorder XPRIZE and is helping lead a new Cancer focused prize), and advises several digital health and technology companies.
Kraft is an avid pilot and served for 14 years as an officer and flight surgeon with F-15 and F-16 fighter squadrons in the Air National Guard. He has conducted research on aerospace medicine that was published with NASA, with whom he was a finalist for astronaut selection.
Daniel Kraft | Speaker | TED.com