TED2009
Daniel Kraft: A better way to harvest bone marrow
Daniel Kraft je izumio bolji način za izvlačenje koštane srži
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Daniel Kraft demonstrira svog Rudara srži -- novi uređaj koji brzo prikuplja koštanu srž koja spašava živote uz minimalnu bol darovatelja. On naglašava da se odrasle matične stanice iz koštane srži mogu koristiti u liječenju mnogih terminalnih oboljenja, od Parkinsonove do srčanih bolesti.
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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Ja sam liječnik za dječji rak
00:21
and stem-cell researcher at Stanford University
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i istraživač matičnih stanica na sveučilištu Stanford
00:25
where my clinical focus has been bone marrow transplantation.
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gdje mi je klinički fokus transplantacija koštane srži.
00:28
Now, inspired by Jill Bolte Taylor last year,
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Inspiriran prošlogodišnjim govorom Jill Bolte Taylor,
00:30
I didn't bring a human brain,
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nisam donio ljudski mozak,
00:32
but I did bring a liter of bone marrow.
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ali samo donio koštanu srž.
00:35
And bone marrow is actually what we use
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A koštana srž je ono što zapravo koristimo
00:38
to save the lives of tens of thousands of patients,
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kako bismo spasili živote desetaka tisuća pacijenata,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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od kojih većina ima uznapredovalu zloćudnost poput leukemije i limfoma
00:43
and some other diseases.
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i neka druga oboljenja.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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Tako, prije nekoliko godina, radim transplantacije kao stipendist na Stanfordu.
00:49
I'm in the operating room. We have Bob here,
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U operacijskoj sam sobi. Ovdje je Bob,
00:51
who is a volunteer donor.
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koji je dobrovoljni darovatelj.
00:53
We're sending his marrow across the country to save the life
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Šaljemo njegovu srž na drugi kraj zemlje da spasi život
00:55
of a child with leukemia.
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djeteta s leukemijom.
00:57
So actually how do we harvest this bone marrow?
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Pa kako zapravo prikupljamo koštanu srž?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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Imamo čitav operacijski tim, anesteziologa, sestre,
01:03
and another doctor across from me.
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i još jednog liječnika preko puta mene.
01:05
Bob's on the table, and we take this sort of small needle,
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Bob je na stolu i imamo ovakvu malu iglu,
01:07
you know, not too big.
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znate, ne preveliku.
01:09
And the way we do this is we basically
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Ono što činimo je
01:11
place this through the soft tissue,
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da je provučemo kroz meko tkivo,
01:13
and kind of punch it into the hard bone,
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i zabijemo je u kost,
01:15
into the tuchus -- that's a technical term --
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u tukus – to je tehnički izraz --
01:17
and aspirate about 10 mls of bone marrow out,
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i izvučemo oko 10 ml koštane srži,
01:21
each time, with a syringe.
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svaki puta, pomoću šprice.
01:23
And hand it off to the nurse. She squirts it into a tin.
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Predajemo je sestri. Ona je isprazni u limenku.
01:26
Hands it back to me. And we do that again and again.
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Dodaje mi opet špricu. I to ponavljamo i ponavljamo.
01:29
About 200 times usually.
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Obično oko 200 puta.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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Dok završim s ovim, ruka mi je utrnula, imam žulj na ruci.
01:33
let alone Bob,
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Da i ne govorim o Bobu,
01:35
whose rear end looks something more like this,
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čija stražnjica izgleda više poput ovoga,
01:37
like Swiss cheese.
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poput švicarskog sira.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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Pa si mislim, znate, ovaj postupak se nije promijenio već 40 godina.
01:43
And there is probably a better way to do this.
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I vjerojatno postoji bolji način da to uradimo.
01:45
So I thought of a minimally invasive approach,
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Pa sam razmišljao o pristupu s minimalnom invazivnošću.
01:48
and a new device that we call the Marrow Miner.
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I o novom uređaju kojega nazivamo Rudar srži.
01:50
This is it.
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Evo ga.
01:52
And the Marrow Miner, the way it works is shown here.
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Rudar srži i način na koji funkcionira su prikazani ovdje.
01:55
Our standard see-through patient.
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Naš standardni prozirni pacijent.
01:57
Instead of entering the bone dozens of times,
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Umjesto da ulazi u kost desetke puta,
01:59
we enter just once, into the front of the hip or the back of the hip.
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ulazimo samo jednom, u prednji dio kuka ili u stražnji dio kuka.
02:01
And we have a flexible, powered catheter
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Imamo i fleksibilan, električni kateter
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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s posebnom omčom od žice na vrhu koja ostaje u srži
02:07
and follows the contours of the hip, as it moves around.
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i prati konture kuka, dok se pomiče unutra.
02:10
So it enables you to very rapidly aspirate,
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To vam omogućava vrlo brzo izvlačenje,
02:12
or suck out, rich bone marrow very quickly through one hole.
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ili isisavanje, bogate koštane srži kroz jedan otvor.
02:15
We can do multiple passes through that same entry.
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Možemo obaviti višestruke prolaze kroz taj isti ulaz.
02:17
No robots required.
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Ne trebaju nam roboti.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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I također, vrlo brzo, Bob može dobiti samo jedan ubod, lokalnu anesteziju,
02:22
and do this harvest as an outpatient.
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i dati srž bez da ostane u bolnici.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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Pa sam napravio nekoliko prototipova. Dobio sam mala bespovratna sredstva na Stanfordu.
02:29
And played around with this a little bit.
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I malo sam se igrao s ovime.
02:31
And our team members developed this technology.
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Članovi našeg tima su razvili ovu tehnologiju.
02:33
And eventually we got two large animals, and pig studies.
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I naposlijetku smo dobili dvije velike životinje, i studije na svinjama.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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I otkrili smo, na naše iznenađenje, da ne samo da smo izvukli koštanu srž,
02:39
but we got 10 times the stem cell activity
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već smo dobili i 10 puta veću aktivnost matične stanice
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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u koštanoj srži izvučenoj pomoću Rudara srži, nego normalnim uređajem.
02:44
This device was just FDA approved in the last year.
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Ovaj uređaj je odobrila FDA prošle godine.
02:47
Here is a live patient. You can see it following the flexible curves around.
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Ovo je pacijent. Vidite da slijedi fleksibilne obline.
02:50
There will be two passes here, in the same patient, from the same hole.
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Ovdje će biti dva prolaza, na istom pacijentu, kroz isti otvor.
02:53
This was done under local anesthesia, as an outpatient.
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Ovo je obavljeno uz lokalnu anesteziju, on ne ostaje u bolnici.
02:55
And we got, again, about three to six times more stem cells
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I dobili smo, opet, tri do šest puta više matičnih stanica
02:58
than the standard approach done on the same patient.
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nego što dobivamo standardnim pristupom kod istog pacijenta.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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Pa, zašto vas to treba zanimati? Koštana srž je vrlo bogat izvor odraslih matičnih stanica.
03:04
You all know about embryonic stem cells.
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Svi znate za matične stanice zametka.
03:06
They've got great potential but haven't yet entered clinical trials.
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One imaju veliki potencijal, ali nisu još podvrgnute kliničkim ispitivanjima.
03:09
Adult stem cells are throughout our body,
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Odrasle matične stanice nalaze nam se u cijelom tijelu,
03:11
including the blood-forming stem cells in our bone marrow,
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uključujući i matične stanice u koštanoj srži koje stvaraju krv.
03:13
which we've been using as a form of stem-cell therapy
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Njih koristimo kao oblik terapije matičnim stanicama
03:15
for over 40 years.
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već više od 40 godina.
03:17
In the last decade there's been an explosion of use
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U posljednjem desetljeću došlo je do eksplozije
03:20
of bone marrow stem cells to treat the patient's other diseases
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korištenja matičnih stanica iz srži za liječenje drugih bolesti
03:23
such as heart disease, vascular disease,
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poput bolesti srca, vaskularnih bolesti,
03:25
orthopedics, tissue engineering,
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ortopedije, proizvodnje tkiva,
03:27
even in neurology to treat Parkinson's
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čak i u neurologiji za liječenje Parkinsonove bolesti,
03:29
and diabetes.
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te dijabetesa.
03:31
We've just come out, we're commercializing, this year,
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Upravo smo izišli, komercijaliziramo, ove godine,
03:33
generation 2.0 of the Marrow Miner.
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generaciju 2.0 Rudara srži.
03:35
The hope is that this gets more stem cells out,
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Nadamo se da će ovo izvući više koštane srži.
03:37
which translates to better outcomes.
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Što daje bolje rezultate.
03:39
It may encourage more people to sign up to be
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Možda će ovo ohrabriti više ljudi da postanu
03:41
potential live-saving bone marrow donors.
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darovatelji srži s potencijalom za spašavanje života.
03:43
It may even enable you to bank
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Moglo bi vam čak omogućiti da pohranite
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your own marrow stem cells, when you're younger and healthier,
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svoje vlastite matične stanice, dok ste mlađi i zdraviji,
03:47
to use in the future should you need it.
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kako biste ih koristili u budućnosti, kad vam zatrebaju.
03:50
And ultimately -- and here's a picture of our
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I najvažnije – ovo je slika pacijenata
03:52
bone marrow transplant survivors,
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koji su preživjeli transplantaciju koštane srži,
03:54
who come together for a reunion each year at Stanford.
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koji se svake godine tradicionalno okupe u Stanfordu.
03:56
Hopefully this technology will let us
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Nadamo se da će nam ova tehnologija omogućiti
03:58
have more of these survivors in the future.
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da imamo više izliječenih u budućnosti.
04:00
Thanks.
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Hvala.
04:02
(Applause)
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(Pljesak)
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