TED2009
Daniel Kraft: A better way to harvest bone marrow
Daniel Kraft inventa uma nova forma de extrair medula óssea
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Daniel Kraft faz uma demontração em seu Marrow Miner -- um aparelho que rapidamente extrai a medula óssea com o mínimo de dor para o doador. Ele reforça que as células tronco adultas encontradas na medula óssea podem ser usadas para tratar muitas doenças terminais, desde Parkinson até doenças do coração.
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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Sou um pediatra oncologista
00:21
and stem-cell researcher at Stanford University
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e pesquisador de células tronco na Universidade de Stanford
00:25
where my clinical focus has been bone marrow transplantation.
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e meu foco clínico tem sido transplante de medula óssea
00:28
Now, inspired by Jill Bolte Taylor last year,
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E inspirado em Jill Taylor ano passado,
00:30
I didn't bring a human brain,
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eu não trouxe um cérebro humano,
00:32
but I did bring a liter of bone marrow.
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mas trouxe um litro de medula óssea.
00:35
And bone marrow is actually what we use
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E medula óssea é o que usamos
00:38
to save the lives of tens of thousands of patients,
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para salvar milhares de vidas de pacientes,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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a maioria portadores de leucemia e linfoma avançados
00:43
and some other diseases.
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entre outras doenças.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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então, ha alguns anos atrás, estava fazendo meu trabalho voluntário de transplante em Stanford.
00:49
I'm in the operating room. We have Bob here,
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Estava na sala de operações. E tinhamos o Bob,
00:51
who is a volunteer donor.
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que era um doador voluntário.
00:53
We're sending his marrow across the country to save the life
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Estavamos enviando sua medula óssea para o outro lado do país para salvar a vida
00:55
of a child with leukemia.
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de uma criança com leucemia.
00:57
So actually how do we harvest this bone marrow?
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Então como extraimos essa medula óssea?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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Bem, temos uma equipe inteira, anestesia geral, enfermeiros,
01:03
and another doctor across from me.
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e um outro médico do outro lado da mesa de operações.
01:05
Bob's on the table, and we take this sort of small needle,
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Bob estava na mesa, e pegamos essa agulha meio pequena,
01:07
you know, not too big.
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sabe, não muito grande.
01:09
And the way we do this is we basically
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E basicamente o que fazemos é
01:11
place this through the soft tissue,
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a inserimos através do tecido macio,
01:13
and kind of punch it into the hard bone,
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e perfuramos o osso duro,
01:15
into the tuchus -- that's a technical term --
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nos tuchus -- termo técnico para nádegas--
01:17
and aspirate about 10 mls of bone marrow out,
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e aspiramos quase 10 mls de medula óssea,
01:21
each time, with a syringe.
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de cada vez, com uma seringa.
01:23
And hand it off to the nurse. She squirts it into a tin.
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E entregamos à enfermeira. Ela esguincha dentro de um recipiente.
01:26
Hands it back to me. And we do that again and again.
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Me devolve. E repetimos isso várias vezes.
01:29
About 200 times usually.
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Mais ou menos 200 vezes, na verdade.
01:31
And by the end of this my arm is sore, I've got a callus on my hand,
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E ao final disso meu braço estava dolorido, fiquei com um calo na mão.
01:33
let alone Bob,
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Ao ser deixado sozinho, Bob,
01:35
whose rear end looks something more like this,
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Cujo traseiro está parecendo mais ou menos com isto,
01:37
like Swiss cheese.
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como queijo suíço.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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E eu fico pensando, sabe, este procedimento não muda há quase 40 anos.
01:43
And there is probably a better way to do this.
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E deve existir um jeito melhor de fazer isso
01:45
So I thought of a minimally invasive approach,
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Então pensei em uma abordagem minimamente invasiva.
01:48
and a new device that we call the Marrow Miner.
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E um novo aparelho que chamamos de Marrow Miner.
01:50
This is it.
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É isto.
01:52
And the Marrow Miner, the way it works is shown here.
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E o Marrow Miner, o jeito que funciona está explicado aqui.
01:55
Our standard see-through patient.
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Nosso paciente padrão.
01:57
Instead of entering the bone dozens of times,
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Ao invés de entrar no osso dúzias de vezes,
01:59
we enter just once, into the front of the hip or the back of the hip.
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entramos apenas uma vez, pela frente o quadril ou por traz
02:01
And we have a flexible, powered catheter
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E temos um poderoso e flexível cateter
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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com uma ponta de argola de arame especia que fica dentro da parte macia da medula
02:07
and follows the contours of the hip, as it moves around.
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segue os contornos do quadril enquanto se movimenta.
02:10
So it enables you to very rapidly aspirate,
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Assim é possivel aspirar rapidamente,
02:12
or suck out, rich bone marrow very quickly through one hole.
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ou sugar, rapidamente a medula óssea através de um buraco.
02:15
We can do multiple passes through that same entry.
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Podemos fazer várias passagens pela mesma entrada.
02:17
No robots required.
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Não são necessários robôs.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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Então, rapidamente, Bob pode ter apena uma picada, anestesia local,
02:22
and do this harvest as an outpatient.
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e fazer a coleta sem que seja necessário ser internado
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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Então eu fiz alguns protótipos. me deram um pequeno presente em Stanford.
02:29
And played around with this a little bit.
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E brinquei com isso um pouco.
02:31
And our team members developed this technology.
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E os membros da nossa equipe desenvolveram esta tecnologia.
02:33
And eventually we got two large animals, and pig studies.
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E eventualmente pegamos animais grandes e outras experiências com porcos.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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E descobrimos, para nossa surpresa, que não apenas extraíamos medula óssea,
02:39
but we got 10 times the stem cell activity
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mas obtínhamos 10 vezes mais células tronco ativas
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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na medula com o Marrow Miner, comparado ao método convencional.
02:44
This device was just FDA approved in the last year.
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Este aparelho acaba de ser aprovado pela FDA no ano passado
02:47
Here is a live patient. You can see it following the flexible curves around.
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Aqui está um paciente ao vivo. Você pode ver o cateter flexível seguindo as curvas.
02:50
There will be two passes here, in the same patient, from the same hole.
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Teremos duas passagens aqui, no mesmo paciente, pelo mesmo buraco.
02:53
This was done under local anesthesia, as an outpatient.
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Isto foi feito com anestesia local, sem internação.
02:55
And we got, again, about three to six times more stem cells
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E extraímos, mais uma vez, cerca de seis vezes mais células tronco
02:58
than the standard approach done on the same patient.
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que com o método comum, feito no mesmo paciente.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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E daí? Medula óssea é uma fonte muito rica de células tronco adultas.
03:04
You all know about embryonic stem cells.
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Vocês conhecem as células tronco embrionárias.
03:06
They've got great potential but haven't yet entered clinical trials.
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Têm muito potencial, mas ainda não chegaram às trilhas da clínica.
03:09
Adult stem cells are throughout our body,
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Celulas tronco adultas estão pelo nosso corpo,
03:11
including the blood-forming stem cells in our bone marrow,
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incluindo as células tronco que formam o sangue na nossa medula óssea.
03:13
which we've been using as a form of stem-cell therapy
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O que temos usado como uma uma forma de terapia célula-tronco
03:15
for over 40 years.
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por 40 anos.
03:17
In the last decade there's been an explosion of use
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Na última década houve uma explosão de uso
03:20
of bone marrow stem cells to treat the patient's other diseases
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de células tronco óssea para o tratamento de outras doenças dos pacientes
03:23
such as heart disease, vascular disease,
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como doenças do coração, doenças vasculares,
03:25
orthopedics, tissue engineering,
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ortopédicas, engenharia de tecidos,
03:27
even in neurology to treat Parkinson's
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até mesmo em neurologia para o tratamento de Parkinson.
03:29
and diabetes.
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e diabetes
03:31
We've just come out, we're commercializing, this year,
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Acabamos de lançar no mercado este ano,
03:33
generation 2.0 of the Marrow Miner.
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a geração 2.0 do Marrow Miner.
03:35
The hope is that this gets more stem cells out,
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A esperança é que assim poderemos extrair mais células tronco.
03:37
which translates to better outcomes.
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O que se transforma em melhores resultados.
03:39
It may encourage more people to sign up to be
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Pode encorajar mais pessoas a se candidatarem a ser
03:41
potential live-saving bone marrow donors.
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doadores de medula óssea e salvar vidas.
03:43
It may even enable you to bank
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Pode até levá-lo a guardar
03:45
your own marrow stem cells, when you're younger and healthier,
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suas próprias células tronco, enquanto está jovem e mais saudável,
03:47
to use in the future should you need it.
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para usar no futuro se precisar.
03:50
And ultimately -- and here's a picture of our
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E no final das contas -- e aqui está uma foto do nosso
03:52
bone marrow transplant survivors,
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sobrevivente transplantado de medula óssea,
03:54
who come together for a reunion each year at Stanford.
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que vem para a reunião anual em Sanford.
03:56
Hopefully this technology will let us
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Tomara que esta tecnologia nos permitirá
03:58
have more of these survivors in the future.
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ter mais desses sobreviventes no futuro.
04:00
Thanks.
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Obrigado.
04:02
(Applause)
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(Aplausos)
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