TED2009
Daniel Kraft: A better way to harvest bone marrow
Daniel Kraft menciptakan cara yang lebih baik untuk mengambil sumsum tulang
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Daniel Kraft mendemonstrasikan Marrow Miner ciptaannya -- sebuah alat baru yang mengambil sumsum tulang penyelamat nyawa dengan cepat dan dengan rasa sakit sesedikit mungkin untuk sang donor. Dia menekankan bahwa stem cell dewasa yang ditemukan dalam sumsum tulang dapat digunakan untuk mengobati banyak penyakit terminal, dari penyakit Parkinson sampai penyakit jantung.
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
Double-click the English transcript below to play the video.
00:18
So I am a pediatric cancer doctor
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Saya adalah seorang dokter kanker anak
00:21
and stem-cell researcher at Stanford University
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dan peneliti stem cell di Universitas Stanford
00:25
where my clinical focus has been bone marrow transplantation.
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di mana transplantasi sumsum tulang telah menjadi fokus klinis saya.
00:28
Now, inspired by Jill Bolte Taylor last year,
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Sekarang, terinspirasi oleh Jill Bolte Taylor tahun lalu,
00:30
I didn't bring a human brain,
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saya tidak membawa otak manusia,
00:32
but I did bring a liter of bone marrow.
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tapi saya membawa seliter sumsum tulang.
00:35
And bone marrow is actually what we use
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Dan sebenarnya sumsum tulang merupakan sesuatu yang kami gunakan
00:38
to save the lives of tens of thousands of patients,
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untuk menyelamatkan nyawa puluhan ribu pasien,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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yang kebanyakan menderita kanker dengan keganasan tingkat lanjut seperti leukemia dan limfoma
00:43
and some other diseases.
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dan beberapa penyakit lainnya.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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Jadi, beberapa tahun lalu, saya sedang melakukan praktek kerja spesialis transplantasi di Stanford.
00:49
I'm in the operating room. We have Bob here,
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Saya di ruang operasi. Di sini ada Bob,
00:51
who is a volunteer donor.
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seorang donor sukarela.
00:53
We're sending his marrow across the country to save the life
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Kami akan mengirim sumsumnya melintasi negeri untuk menyelamatkan nyawa
00:55
of a child with leukemia.
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seorang anak yang terkena leukemia.
00:57
So actually how do we harvest this bone marrow?
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Jadi bagaimana sebenarnya kami mengambil sumsum tulang ini?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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Kami mempunyai tim bedah lengkap, dengan dokter anestesi umum, suster-suster,
01:03
and another doctor across from me.
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dan seorang dokter lain di hadapan saya.
01:05
Bob's on the table, and we take this sort of small needle,
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Bob berbaring di meja operasi, dan kami mengambil satu jarum kecil,
01:07
you know, not too big.
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Anda tahu, tidak terlalu besar.
01:09
And the way we do this is we basically
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Dan cara kami melakukan ini adalah pada dasarnya kami
01:11
place this through the soft tissue,
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menempatkan ini melewati jaringan lunak,
01:13
and kind of punch it into the hard bone,
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dan seperti melubanginya ke dalam tulang keras,
01:15
into the tuchus -- that's a technical term --
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ke dalam bokong -- itu istilah teknis --
01:17
and aspirate about 10 mls of bone marrow out,
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dan menyedot keluar sekitar 10 ml sumsum tulang,
01:21
each time, with a syringe.
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setiap kalinya, dengan sebuah suntikan.
01:23
And hand it off to the nurse. She squirts it into a tin.
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Dan memberinya kepada suster. Dia akan menyemprotkannya ke dalam sebuah kaleng.
01:26
Hands it back to me. And we do that again and again.
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Diberikan kembali kepada saya. Dan kami melakukan itu berulang kali.
01:29
About 200 times usually.
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Biasanya sekitar 200 kali.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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Dan pada akhirnya lengan saya sakit, ada kapalan di tangan saya.
01:33
let alone Bob,
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Jangankan Bob,
01:35
whose rear end looks something more like this,
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yang bagian belakangnya terlihat lebih seperti ini,
01:37
like Swiss cheese.
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seperti keju swiss.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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Jadi saya berpikir, Anda tahu, prosedur ini tidak pernah berubah selama 40 tahun.
01:43
And there is probably a better way to do this.
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Dan mungkin ada cara yang lebih baik untuk melakukan ini.
01:45
So I thought of a minimally invasive approach,
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Jadi saya memikirkan pendekatan invasif minimal.
01:48
and a new device that we call the Marrow Miner.
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Dan sebuah alat baru yang kami namakan Marrow Miner.
01:50
This is it.
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Ini dia.
01:52
And the Marrow Miner, the way it works is shown here.
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Dan Marrow Miner, cara bekerjanya ditampilkan di sini.
01:55
Our standard see-through patient.
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Seorang pasien transparan biasa.
01:57
Instead of entering the bone dozens of times,
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Daripada memasuki tulang berlusin kali,
01:59
we enter just once, into the front of the hip or the back of the hip.
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kami masuk hanya sekali, ke depan pinggul atau belakang pinggul.
02:01
And we have a flexible, powered catheter
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Dan kami punya sebuah kateter bermotor dan fleksibel
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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dengan ujung kawat berputar istimewa yang menetap di dalam bagian renyah dari sumsum
02:07
and follows the contours of the hip, as it moves around.
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dan bergerak mengikuti lekukan-lekukan pinggul.
02:10
So it enables you to very rapidly aspirate,
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Jadi itu menyanggupkan Anda untuk dengan sangat cepat menyedot,
02:12
or suck out, rich bone marrow very quickly through one hole.
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atau mengisap keluar, sumsum tulang yang subur melalui satu lubang.
02:15
We can do multiple passes through that same entry.
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Kami bisa melakukan beberapa lewatan dari tempat masuk yang sama.
02:17
No robots required.
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Tidak perlu robot.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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Dan, jadi, dengan cepat, Bob hanya mendapat satu tusukan, pembiusan lokal,
02:22
and do this harvest as an outpatient.
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dan melakukan prosedur ini sebagai pasien rawat jalan.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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Jadi saya membuat beberapa prototipe. Saya mendapat sedikit hibah kecil dari Stanford.
02:29
And played around with this a little bit.
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Dan bermain-main sedikit dengan ini.
02:31
And our team members developed this technology.
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Dan anggota tim kami mengembangkan teknologi ini.
02:33
And eventually we got two large animals, and pig studies.
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Dan akhirnya kami dapat dua hewan besar, dan studi pada babi.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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Dan yang mengejutkan, kami menemukan bahwa kami tidak hanya mengeluarkan sumsum tulang,
02:39
but we got 10 times the stem cell activity
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tapi kami mendapat aktivitas stem cell 10 kali lipat
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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di dalam sumsum yang diambil dengan Marrow Miner, dibandingkan dengan alat biasa.
02:44
This device was just FDA approved in the last year.
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Alat ini baru saja disetujui FDA dalam setahun terakhir ini.
02:47
Here is a live patient. You can see it following the flexible curves around.
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Di sini ada seorang pasien hidup. Anda dapat melihat alat ini mengikuti lekukan-lekukan fleksibel.
02:50
There will be two passes here, in the same patient, from the same hole.
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Di sini akan ada dua lewatan, di dalam pasien yang sama, dari lubang yang sama.
02:53
This was done under local anesthesia, as an outpatient.
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Ini dilakukan dengan pembiusan lokal, sebagai pasien rawat jalan.
02:55
And we got, again, about three to six times more stem cells
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Dan kami mendapatkan, lagi, stem cell sekitar tiga sampai enam kali lipat lebih banyak
02:58
than the standard approach done on the same patient.
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daripada cara standar ketika dilakukan pada pasien yang sama.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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Jadi mengapa Anda harus peduli? Sumsum tulang adalah sumber yang kaya akan stem cell dewasa.
03:04
You all know about embryonic stem cells.
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Anda semua tahu tentang stem cell janin.
03:06
They've got great potential but haven't yet entered clinical trials.
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Mereka mempunyai potensi besar tapi belum memasuki uji klinis.
03:09
Adult stem cells are throughout our body,
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Stem cell dewasa terdapat di seluruh tubuh kita,
03:11
including the blood-forming stem cells in our bone marrow,
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termasuk stem cell pembentuk darah di dalam sumsum tulang kita.
03:13
which we've been using as a form of stem-cell therapy
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Kami telah menggunakan ini sebagai semacam terapi stem cell
03:15
for over 40 years.
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selama lebih dari 40 tahun.
03:17
In the last decade there's been an explosion of use
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Di dalam dekade terakhir telah ada ledakan penggunaan
03:20
of bone marrow stem cells to treat the patient's other diseases
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stem cell sumsum tulang untuk mengobati penyakit lain sang pasien
03:23
such as heart disease, vascular disease,
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seperti penyakit jantung, penyakit pembuluh darah,
03:25
orthopedics, tissue engineering,
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bedah ortopedi, rekayasa jaringan,
03:27
even in neurology to treat Parkinson's
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bahkan dalam neurologi untuk mengobati penyakit Parkinson,
03:29
and diabetes.
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dan diabetes.
03:31
We've just come out, we're commercializing, this year,
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Kami baru saja mengeluarkan, mengkomersilkan, tahun ini,
03:33
generation 2.0 of the Marrow Miner.
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Marrow Miner generasi 2.0.
03:35
The hope is that this gets more stem cells out,
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Harapan kami adalah bahwa ini dapat mengeluarkan lebih banyak stem cell.
03:37
which translates to better outcomes.
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Yang berarti hasil-hasil yang lebih baik.
03:39
It may encourage more people to sign up to be
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Ini mungkin mendorong lebih banyak orang untuk mendaftar menjadi
03:41
potential live-saving bone marrow donors.
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donor sumsum tulang yang berpotensi menyelamatkan nyawa.
03:43
It may even enable you to bank
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Ini bahkan memungkinkan Anda untuk menabung
03:45
your own marrow stem cells, when you're younger and healthier,
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stem cell sumsum Anda sendiri, ketika Anda lebih muda dan lebih sehat,
03:47
to use in the future should you need it.
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untuk digunakan di masa mendatang, kalau Anda membutuhkannya.
03:50
And ultimately -- and here's a picture of our
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Dan yang terakhir -- ini adalah foto dari
03:52
bone marrow transplant survivors,
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pasien transplantasi sumsum tulang yang selamat,
03:54
who come together for a reunion each year at Stanford.
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yang berkumpul untuk acara reuni setiap tahun di Stanford.
03:56
Hopefully this technology will let us
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Semoga teknologi ini dapat membantu kita untuk
03:58
have more of these survivors in the future.
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mendapatkan lebih banyak pasien yang selamat di masa mendatang.
04:00
Thanks.
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Terima kasih.
04:02
(Applause)
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(Tepuk tangan)
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