TED2009
Daniel Kraft: A better way to harvest bone marrow
Danijel Kraft (Daniel Kraft) pronalazi bolji način za sakupljanje koštane srži
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Danijel Kraft (Daniel Kraft) nam prikazuje svoj Tučak za koštanu srž - novi uređaj koji efikasno i brzo sakuplja koštanu srž koja spašava živote, a sve to uz minimalan bol kojem je davalac srži izložen. On naglašava da se matične ćelije odraslih ljudi koje se nalaze u koštanoj srži mogu koristiti kao tretman pri lečenju mnogih teških bolesti, od Parkinosonove bolesti do bolesti srca.
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 dečiji onkolog,
00:21
and stem-cell researcher at Stanford University
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i bavim se istraživanjem matičnih ćelija na Univerzitetu Stanford,
00:25
where my clinical focus has been bone marrow transplantation.
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a glavna tema mojih istraživanja jeste transplantacija koštane srži.
00:28
Now, inspired by Jill Bolte Taylor last year,
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Inspirisan prošlogodišnjim govorom Džil Bolt Tejlora,
00:30
I didn't bring a human brain,
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nisam doneo ljudski mozak,
00:32
but I did bring a liter of bone marrow.
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već litar koštane srži.
00:35
And bone marrow is actually what we use
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Koristimo koštanu srž kako bismo
00:38
to save the lives of tens of thousands of patients,
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spasili živote desetina hiljada pacijenata,
00:40
most of whom have advanced malignancies like leukemia and lymphoma
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od kojih većina boluje od odmaklih malignih oboljenja kao što su leukemija i limfoma,
00:43
and some other diseases.
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kao i neke druge bolesti.
00:45
So, a few years ago, I'm doing my transplant fellowship at Stanford.
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Pre nekoliko godina sam radio svoju specijalizaciju u oblasti transplantacije na Stanfordu.
00:49
I'm in the operating room. We have Bob here,
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Nalazim se u operacionoj sali. Tamo je i Bob,
00:51
who is a volunteer donor.
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donor-volonter.
00:53
We're sending his marrow across the country to save the life
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Šaljemo ga po celoj državi da spašava živote
00:55
of a child with leukemia.
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dece koja boluju od leukemije.
00:57
So actually how do we harvest this bone marrow?
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Pa, kako mi ustvari sakupljamo koštanu srž?
00:59
Well we have a whole O.R. team, general anesthesia, nurses,
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Imamo ceo tim za operacije, opšteg anesteziologa, medicinske sestre
01:03
and another doctor across from me.
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i još jednog lekara 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 operacionom stolu, a mi uzmemo malu iglu,
01:07
you know, not too big.
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znate već, ne baš preveliku.
01:09
And the way we do this is we basically
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Uradimo proceduru tako što je u principu
01:11
place this through the soft tissue,
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probijemo kroz meko tkivo,
01:13
and kind of punch it into the hard bone,
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i zabodemo je u tvrdu kost,
01:15
into the tuchus -- that's a technical term --
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u tuhus - 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 put kada zabodemo iglu.
01:23
And hand it off to the nurse. She squirts it into a tin.
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Potom to predamo sestri. Ona isprazni sadržaj igle u posudu.
01:26
Hands it back to me. And we do that again and again.
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Ponovo mi je doda. I onda mi to radimo nanovo i nanovo,
01:29
About 200 times usually.
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uglavnom 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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Kada završimo proceduru mene boli ruka, izašao mi je žulj,
01:33
let alone Bob,
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a da vam ne pričam o Bobu
01:35
whose rear end looks something more like this,
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čija zadnjica i izgleda otprilike ovako,
01:37
like Swiss cheese.
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kao švajcarski sir.
01:39
So I'm thinking, you know, this procedure hasn't changed in about 40 years.
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Tada sam pomislio, znate, ova procedura se nije promenila u poslednjih 40 godina.
01:43
And there is probably a better way to do this.
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Siguran sam da postoji bolji način da se to uradi.
01:45
So I thought of a minimally invasive approach,
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Počeo sam da razmišljam o minimalno invazivnoj proceduri
01:48
and a new device that we call the Marrow Miner.
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i novom uređaju koji zovemo Tučak koštane srži.
01:50
This is it.
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To je ovo.
01:52
And the Marrow Miner, the way it works is shown here.
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Način na koji Tučak koštane srži radi je pokazan ovde.
01:55
Our standard see-through patient.
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Ovo je naš uobičajeni pacijent.
01:57
Instead of entering the bone dozens of times,
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Umesto da probadamo kost desetinama puta,
01:59
we enter just once, into the front of the hip or the back of the hip.
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samo jednom probodemo kost, sa prednje ili zadnje strane kuka.
02:01
And we have a flexible, powered catheter
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Uređaj ima fleksibilan kateter koji radi na baterije,
02:04
with a special wire loop tip that stays inside the crunchy part of the marrow
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i špatulicu od žice na vrhu koja zadire u hrskavi deo srži
02:07
and follows the contours of the hip, as it moves around.
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i dok se pomera, prati linije kuka.
02:10
So it enables you to very rapidly aspirate,
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Ovo vam omogućava da veoma brzo aspirirate,
02:12
or suck out, rich bone marrow very quickly through one hole.
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ili izvučete bogatu koštanu srž kroz jednu rupu.
02:15
We can do multiple passes through that same entry.
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Možemo nekoliko puta da prođemo kroz isti ulaz u kost.
02:17
No robots required.
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Nisu nam potrebni roboti.
02:19
And, so, very quickly, Bob can just get one puncture, local anesthesia,
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Tako da Bobu možemo dati samo lokalnu anesteziju, probodemo njegovu kost jednom,
02:22
and do this harvest as an outpatient.
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i uradimo ceo zahvat bez hospitalizacije.
02:26
So I did a few prototypes. I got a small little grant at Stanford.
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Napravio sam nekoliko modela. Dobio sam malu stipendiju za to na Stanfordu.
02:29
And played around with this a little bit.
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Zanimao sam se ovim neko vreme.
02:31
And our team members developed this technology.
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Članovi našeg tima su zajedno razvili ovu tehnologiju.
02:33
And eventually we got two large animals, and pig studies.
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Na kraju smo došli do dve velike životinje i studija na svinjama.
02:37
And we found, to our surprise, that we not only got bone marrow out,
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Na naše iznenađenje, pronašli smo da ne samo da uspevamo da izvučemo koštanu srž već
02:39
but we got 10 times the stem cell activity
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da smo dobili matičnim ćelijama 10 puta obogaćeniju srž
02:42
in the marrow from the Marrow Miner, compared to the normal device.
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uz pomoć Tučka koštane srži u poređenju sa regularnim napravama.
02:44
This device was just FDA approved in the last year.
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Ovaj uređaj je prošle godine odobren od strane FDA (Agencije za hranu i lekove).
02:47
Here is a live patient. You can see it following the flexible curves around.
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Ovo je stvarni pacijent. Možete videti kako prati savitljive krivine unaokolo.
02:50
There will be two passes here, in the same patient, from the same hole.
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Napravićemo dva zahveta ovde, na istom pacijentu, kroz istu rupu.
02:53
This was done under local anesthesia, as an outpatient.
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Ovo je sve urađeno u lokalnoj anesteziji, bez hospitalizacije donora.
02:55
And we got, again, about three to six times more stem cells
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Ponovo smo dobili tri do šest puta više matičnih ćelija u odnosu
02:58
than the standard approach done on the same patient.
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na standardnu proceduru koja je urađena na ovom istom pacijentu.
03:01
So why should you care? Bone marrow is a very rich source of adult stem cells.
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Zašto je ovo važno? Koštana srž je veoma bogat izvor matičnih ćelija odraslih ljudi.
03:04
You all know about embryonic stem cells.
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Svi znate o embrionalnim, matičnim ćelijama.
03:06
They've got great potential but haven't yet entered clinical trials.
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U njima leži veliki potencijal, ali i ih dalje ne korisitmo u kliničkim istraživanjima.
03:09
Adult stem cells are throughout our body,
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Matične ćelije odraslih osoba se nalaze u celom telu,
03:11
including the blood-forming stem cells in our bone marrow,
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uključujući i ćelije od kojih nastaje krv u našoj koštanoj srži,
03:13
which we've been using as a form of stem-cell therapy
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koje koristimo već preko 40 godina
03:15
for over 40 years.
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kao vid terapije matičnim ćelijama.
03:17
In the last decade there's been an explosion of use
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Tokom poslednje decenije došlo je do procvata upotrebe
03:20
of bone marrow stem cells to treat the patient's other diseases
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matičnih ćelija koštane srži u lečenju različitih bolesti
03:23
such as heart disease, vascular disease,
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kao što su srčana bolest, bolest krvnih sudova,
03:25
orthopedics, tissue engineering,
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potom u ortopediji, u inženjeringu tkiva,
03:27
even in neurology to treat Parkinson's
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a u neurologiji se čak koriste za lečenje Parkinsonove bolesti
03:29
and diabetes.
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i dijabetesa.
03:31
We've just come out, we're commercializing, this year,
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Upravo smo izbacili na tržište i ove godine komercijalizujemo
03:33
generation 2.0 of the Marrow Miner.
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novu verziju Tučka koštane srži.
03:35
The hope is that this gets more stem cells out,
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Nadamo se da ćemo ovim putem doći do više matičnih ćelija
03:37
which translates to better outcomes.
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što znači da ćemo imati bolje rezultate tretmana.
03:39
It may encourage more people to sign up to be
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To može ohrabriti više ljudi da se registruju kao
03:41
potential live-saving bone marrow donors.
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davaoci srži što potencijalno može spasiti živote ljudi.
03:43
It may even enable you to bank
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To vam može omogućiti da uskladištite vaše
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your own marrow stem cells, when you're younger and healthier,
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sopstvene matične ćelije dok ste mlađi i zdraviji,
03:47
to use in the future should you need it.
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i koristite ih kasnije ako vam zatrebaju.
03:50
And ultimately -- and here's a picture of our
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Na kraju-- ovo je slika ljudi koji su preživeli
03:52
bone marrow transplant survivors,
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transplantacije koštane srži,
03:54
who come together for a reunion each year at Stanford.
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koji se svake godine okupe na 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 povećamo broj uspešno izlečenih ljudi u budućnosti.
04:00
Thanks.
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Hvala vam.
04:02
(Applause)
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(Aplauz).
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