TED2009
Daniel Kraft: A better way to harvest bone marrow
Daniel Kraft opfinder en bedre måde at høste knoglemarv
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Daniel Kraft demonstrerer sin Marvgraver -- et nyt apparat, der hurtigt høster livreddende knoglemarv med minimal smerte for donoren. Han understreger, at voksenstamcellerne i knoglemarv kan bruges til at behandle mange terminaltilstande fra Parkinsons til hjertesygdom.
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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Jeg er speciallæge i børnecancer
00:21
and stem-cell researcher at Stanford University
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og forsker i stamceller på Stanford Universitet,
00:25
where my clinical focus has been bone marrow transplantation.
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hvor mit kliniske fokus har været knoglemarvstransplantation.
00:28
Now, inspired by Jill Bolte Taylor last year,
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Inspireret af Jill Bolte Taylor sidste år
00:30
I didn't bring a human brain,
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tog jeg ikke en hjerne med,
00:32
but I did bring a liter of bone marrow.
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men jeg tog en liter knoglemarv.
00:35
And bone marrow is actually what we use
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Og knoglemarv bruger vi faktisk
00:38
to save the lives of tens of thousands of patients,
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til at redde titusindvis af patienters liv,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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hvoraf de fleste har fremskredne lidelser som leukæmi og lymfoma
00:43
and some other diseases.
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og andre sygdomme.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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For et par år siden er jeg transplantations-fellow på Stanford.
00:49
I'm in the operating room. We have Bob here,
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Jeg er på operationsstuen. Her har vi Bob,
00:51
who is a volunteer donor.
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der er frivillig donor.
00:53
We're sending his marrow across the country to save the life
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Vi sender hans marv på tværs af landet for at redde
00:55
of a child with leukemia.
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et leukæmiramt barn.
00:57
So actually how do we harvest this bone marrow?
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Hvordan høster vi knoglemarv?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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Vi har et operationshold, anæstesi, sygeplejersker
01:03
and another doctor across from me.
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og en anden læge foran mig.
01:05
Bob's on the table, and we take this sort of small needle,
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Bob er på bordet, og vi tager denne lille nål,
01:07
you know, not too big.
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ikke særlig stor.
01:09
And the way we do this is we basically
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Og grundlæggende placerer vi
01:11
place this through the soft tissue,
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den gennem det bløde væv
01:13
and kind of punch it into the hard bone,
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og presser den ind i den hårde knogle
01:15
into the tuchus -- that's a technical term --
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ind i tuchus -- det er et fagord --
01:17
and aspirate about 10 mls of bone marrow out,
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og suger omkring 10 ml knoglemarv ud
01:21
each time, with a syringe.
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hver gang med en kanyle.
01:23
And hand it off to the nurse. She squirts it into a tin.
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Og giver det til sygeplejersken. Hun sprøjter det i en dåse.
01:26
Hands it back to me. And we do that again and again.
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Giver mig den. Og vi gør det igen og igen.
01:29
About 200 times usually.
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Omkring 200 gange.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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Og til sidst er min arm øm, jeg får hård hud på hånden,
01:33
let alone Bob,
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for ikke at tale om Bob,
01:35
whose rear end looks something more like this,
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hvis bagdel mere ligner dette,
01:37
like Swiss cheese.
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Schweizisk ost.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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Så jeg tænker, denne procedure har været uforandret i 40 år.
01:43
And there is probably a better way to do this.
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Der er nok en bedre fremgangsmåde.
01:45
So I thought of a minimally invasive approach,
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Jeg kom på en minimalt invasiv metode
01:48
and a new device that we call the Marrow Miner.
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og et nyt apparat, vi kalder Marvgraveren.
01:50
This is it.
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Her er den.
01:52
And the Marrow Miner, the way it works is shown here.
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Her kan I se hvordan Marvgraveren virker.
01:55
Our standard see-through patient.
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Vores standard gennemsigtige patient.
01:57
Instead of entering the bone dozens of times,
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Frem for at trænge ind i knoglen dusinvis af gange,
01:59
we enter just once, into the front of the hip or the back of the hip.
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kan vi trænge ind én gang, ind i hoften forfra eller bagfra.
02:01
And we have a flexible, powered catheter
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Og vi har et fleksibelt, eldrevet kateter
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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med en speciel rund ledningsspids, der bliver i marvens knasende del
02:07
and follows the contours of the hip, as it moves around.
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og følger hoftens konturer, mens den bevæger sig rundt.
02:10
So it enables you to very rapidly aspirate,
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Den muliggør hurtigt at opsuge
02:12
or suck out, rich bone marrow very quickly through one hole.
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eller udsuge rig knoglemarv hurtigt gennem ét hul.
02:15
We can do multiple passes through that same entry.
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Vi kan tage flere runder gennem den ene indgang.
02:17
No robots required.
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Uden robotter.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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Derfor kan Bob nøjes med ét hul, lokalbedøvelse
02:22
and do this harvest as an outpatient.
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og blive høstet som ambulant patient.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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Jeg lavede nogle prototyper. Jeg fik et lille stipendium fra Stanford.
02:29
And played around with this a little bit.
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Og legede lidt med denne.
02:31
And our team members developed this technology.
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Vores hold udviklede teknologien.
02:33
And eventually we got two large animals, and pig studies.
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Endelig fik vi to store dyr og forsøg med grise.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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Vi fandt, at vi ikke kun fik knoglemarv ud
02:39
but we got 10 times the stem cell activity
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men vi fik 10 gange højere stamcelleaktivitet
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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i marven fra Marvgraveren, i forhold til det normale apparat.
02:44
This device was just FDA approved in the last year.
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Apparatet her blev godkendt sidste år.
02:47
Here is a live patient. You can see it following the flexible curves around.
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Her er en levende patient. I kan se, det følger kurverne.
02:50
There will be two passes here, in the same patient, from the same hole.
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Her er to runder fra samme patient, samme hul.
02:53
This was done under local anesthesia, as an outpatient.
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Dette blev gjort under lokalbedøvelse som ambulant patient.
02:55
And we got, again, about three to six times more stem cells
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Igen fik vi omkring tre til seks gange flere stamceller
02:58
than the standard approach done on the same patient.
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end standardfremgangsmåden på samme patient.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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Hvorfor skulle I kere jer? Knoglemarv er en rig kilde til voksenstamceller.
03:04
You all know about embryonic stem cells.
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I kender alle embryoniske stamceller.
03:06
They've got great potential but haven't yet entered clinical trials.
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De har stort potentiale, men er endnu ikke i kliniske forsøg.
03:09
Adult stem cells are throughout our body,
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Voksenstamceller er i hele kroppen,
03:11
including the blood-forming stem cells in our bone marrow,
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også bloddannende stamceller er i vores knoglemarv,
03:13
which we've been using as a form of stem-cell therapy
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som vi har benyttet som en art stamcelleterapi
03:15
for over 40 years.
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i over 40 år.
03:17
In the last decade there's been an explosion of use
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I det seneste årti har der været en eksplosion i brugen
03:20
of bone marrow stem cells to treat the patient's other diseases
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af knoglemarvsstamceller for at behandle patientens andre sygdomme
03:23
such as heart disease, vascular disease,
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som hjerte-kar-sygdomme,
03:25
orthopedics, tissue engineering,
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ortopædi, vævsmanipulation,
03:27
even in neurology to treat Parkinson's
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selv i neurologi til at behandle Parkinsons
03:29
and diabetes.
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og diabetes.
03:31
We've just come out, we're commercializing, this year,
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Vi er lige udkommet, vi kommercialiserer i år
03:33
generation 2.0 of the Marrow Miner.
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generation 2,0 af Marvgraveren.
03:35
The hope is that this gets more stem cells out,
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Håbet er, at dette får flere stamceller ud,
03:37
which translates to better outcomes.
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hvilket viser sig i bedre udfald.
03:39
It may encourage more people to sign up to be
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Det kan opfordre flere til at skrive sig op til at være
03:41
potential live-saving bone marrow donors.
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potentielt livreddende knoglemarvsdonorer.
03:43
It may even enable you to bank
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Det muliggør måske at sætte
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your own marrow stem cells, when you're younger and healthier,
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sin marvstamceller i banken, mens man er yngre og raskere
03:47
to use in the future should you need it.
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til brug i fremtiden, skulle det blive nødvendigt.
03:50
And ultimately -- and here's a picture of our
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Og ultimativt -- her er et billede af vores
03:52
bone marrow transplant survivors,
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knoglemarvstransplantations-overlevende,
03:54
who come together for a reunion each year at Stanford.
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som kommer sammen til en genforening hvert år på Stanford.
03:56
Hopefully this technology will let us
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Forhåbentlig vil denne teknologi lade os
03:58
have more of these survivors in the future.
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have flere af disse overlevende i fremtiden.
04:00
Thanks.
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Tak.
04:02
(Applause)
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(Bifald)
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