TEDMED 2009
Anthony Atala: Growing new organs
阿特拉.安东尼讲述新器官的培育
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阿特拉.安东尼的尖端实验室培育人体器官-如肌肉，血管，膀胱等。在TEDMED，他展示了他的一些使用如科幻小说描述的小玩意进行生物工程的片段，其中包含像烤箱一样的生物反应器（预热到98.6华氏度）以及一台“打印”人体组织的机器。
Anthony Atala - Surgeon
Anthony Atala asks, "Can we grow organs instead of transplanting them?" His lab at the Wake Forest Institute for Regenerative Medicine is doing just that -- engineering over 30 tissues and whole organs. Full bio
Anthony Atala asks, "Can we grow organs instead of transplanting them?" His lab at the Wake Forest Institute for Regenerative Medicine is doing just that -- engineering over 30 tissues and whole organs. Full bio
Double-click the English transcript below to play the video.
00:15
This is actually a painting
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这实际上是一幅画，
00:18
that hangs at the Countway Library at Harvard Medical School.
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它挂在哈佛医学院Countway图书馆的墙上
00:21
And it shows the first time an organ was ever transplanted.
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记录了第一次器官移植。
00:25
In the front, you see, actually, Joe Murray
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在前面，你看，那是约翰.穆雷
00:28
getting the patient ready for the transplant,
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正为病人做准备，接受移植
00:30
while in the back room you see Hartwell Harrison,
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在房间后面，你会看见哈德威.哈罗孙
00:32
the Chief of Urology at Harvard,
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哈佛医学院泌尿科主任
00:35
actually harvesting the kidney.
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正在摘除肾脏。
00:37
The kidney was indeed the first organ
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这个肾脏是第一个
00:39
ever to be transplanted to the human.
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移植到人体上的器官。
00:41
That was back in 1954,
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这发生在1954年
00:44
55 years ago.
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55年前，
00:46
Yet we're still dealing with a lot of the same challenges
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那时他们正应对非常多挑战，
00:49
as many decades ago.
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如同多年前一样。
00:51
Certainly many advances, many lives saved.
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当然有很多进步，拯救了很多生命，
00:54
But we have a major shortage of organs.
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但我们却非常缺乏器官。
00:58
In the last decade the number of patients
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在过去十年，等待移植的病人数量
01:01
waiting for a transplant has doubled.
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已经翻倍，
01:04
While, at the same time, the actual number of transplants
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但与此同时，移植的数量
01:06
has remained almost entirely flat.
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却基本不变。
01:09
That really has to do with our aging population.
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这主要是因为我们老龄化的人口。
01:11
We're just getting older.
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我们正在变老。
01:13
Medicine is doing a better job
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医疗效果变好了，
01:16
of keeping us alive.
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使我们能活得更长。
01:18
But as we age, our organs tend to fail more.
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但随着我们变老，器官也越来越容易生病
01:21
So, that's a challenge,
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所以，这是一个挑战。
01:23
not just for organs but also for tissues.
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对于器官，组织都是如此。
01:25
Trying to replace pancreas,
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试图替换胰腺，
01:28
trying to replace nerves that can help us with Parkinson's.
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试图替换神经，来帮助治疗帕金森综合症，
01:33
These are major issues.
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那些是主要的组织。
01:35
This is actually a very stunning statistic.
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这事实上是非常惊人的数据，
01:39
Every 30 seconds
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每30秒钟
01:41
a patient dies from diseases
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就有一个病人死于
01:44
that could be treated with tissue regeneration or replacement.
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可用替换组织治疗的疾病。
01:48
So, what can we do about it?
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那，我们要怎么解决？
01:51
We've talked about stem cells tonight.
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今晚我们已谈论了干细胞
01:53
That's a way to do it.
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这是一个解决的办法。
01:55
But still ways to go to get stem cells into patients,
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但仍需方法把干细胞植入病人体中。
02:00
in terms of actual therapies for organs.
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如果说我们要真（用干细胞）治疗（得病了的）器官。
02:03
Wouldn't it be great if our bodies could regenerate?
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若我们的身体能再生岂不是很好？
02:06
Wouldn't it be great if we could actually harness the power
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若我们能管理身体的力量
02:09
of our bodies, to actually heal ourselves?
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来治愈自己，岂不是很好？
02:14
It's not really that foreign of a concept, actually;
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事实上，这不是一个怪异的概念，
02:17
it happens on the Earth every day.
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每天地球上都在发生。
02:21
This is actually a picture of a salamander.
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这是火蜥蜴的一幅图片，
02:24
Salamanders have this amazing capacity to regenerate.
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火蜥蜴就有这种自我再生的奇特能力。
02:28
You see here a little video.
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请看这个小片段
02:30
This is actually a limb injury in this salamander.
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这是火蜥蜴腿上受的伤
02:34
And this is actually real photography,
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这是一幅真的图片，
02:36
timed photography, showing how that limb regenerates
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按时间排列的照片，展示了受伤的腿
02:39
in a period of days.
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经过一段时间后再生的过程。
02:41
You see the scar form.
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请看这个伤疤，
02:43
And that scar actually grows out
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这个伤疤会长出来
02:46
a new limb.
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一条新腿。
02:48
So, salamanders can do it.
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所以，火蜥蜴能做到再生。
02:50
Why can't we? Why can't humans regenerate?
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为什么我们不能？为什么人类不能再生？
02:53
Actually, we can regenerate.
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事实上，我们可以再生。
02:57
Your body has many organs
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你的身体有很多器官。
03:01
and every single organ in your body
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你身体的每一个器官，
03:03
has a cell population
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都有一定数量的细胞
03:05
that's ready to take over at the time of injury. It happens every day.
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在你受伤时，会进行替代。这每天都在发生。
03:10
As you age, as you get older.
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当你变老，
03:13
Your bones regenerate every 10 years.
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你的骨骼会每十年再生一次，
03:16
Your skin regenerates every two weeks.
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你的皮肤每两周再生一次。
03:19
So, your body is constantly regenerating.
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所以，你的身体一直再进行着再生。
03:21
The challenge occurs when there is an injury.
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当受伤时，我们就有挑战了。
03:23
At the time of injury or disease,
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当受伤或生病时，
03:26
the body's first reaction
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身体的第一个反应
03:29
is to seal itself off from the rest of the body.
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是将这部分与身体其它部分隔离开
03:32
It basically wants to fight off infection,
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来抵抗感染。
03:34
and seal itself, whether it's organs inside your body,
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进行治疗，你身体内的器官
03:38
or your skin, the first reaction
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或是你的皮肤，第一个反应
03:41
is for scar tissue to move in,
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就是让伤疤组织行动
03:43
to seal itself off from the outside.
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与外界进行隔离
03:47
So, how can we harness that power?
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那我们要怎么管理这种能力呢？
03:49
One of the ways that we do that
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方法之一是
03:51
is actually by using smart biomaterials.
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使用智能生物材料
03:56
How does this work? Well, on the left side here
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这是怎么生效的呢？在左边
03:59
you see a urethra which was injured.
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是一个受伤的尿道
04:01
This is the channel that connects the bladder to the outside of the body.
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这是连接膀胱与身体外部的通道。
04:05
And you see that it is injured.
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你看它已经受伤
04:07
We basically found out that you can use these smart biomaterials
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基本上，我们发现你可以使用那些智能材料
04:11
that you can actually use as a bridge.
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（在受伤的地方）作为桥梁。
04:14
If you build that bridge, and you close off
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受伤的组织会（愈合然后）
04:17
from the outside environment,
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与外部环境隔离开来，
04:19
then you can create that bridge, and cells
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有了这座桥梁，
04:22
that regenerate in your body,
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你身体内再生的细胞
04:24
can then cross that bridge, and take that path.
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可以爬上这座桥，用它作为通道（来重建尿道）。
04:28
That's exactly what you see here.
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这就是你现在看到的事实
04:30
It's actually a smart biomaterial
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这实际上是一个智能生物材料。
04:32
that we used, to actually treat this patient.
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我们使用它治好了这位病人。
04:34
This was an injured urethra on the left side.
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这是在左边的一个受伤的尿道。
04:37
We used that biomaterial in the middle.
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我们在中间使用智能材料，
04:39
And then, six months later on the right-hand side
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6个月后，在右边，
04:42
you see this reengineered urethra.
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你看这是再生的尿道。
04:44
Turns out your body can regenerate,
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其实我们的身体可以再生
04:46
but only for small distances.
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但只能在小距离的情况下
04:49
The maximum efficient distance for regeneration
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再生细胞能走的最大距离
04:52
is only about one centimeter.
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是1厘米。
04:54
So, we can use these smart biomaterials
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所以，我们可以用这些智能材料
04:57
but only for about one centimeter
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进行1厘米的再生
05:00
to bridge those gaps.
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来治愈这些伤口
05:02
So, we do regenerate, but for limited distances.
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所以，我们可以再生，但只能短距离再生
05:05
What do we do now,
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我们怎么做才能（治疗病人）
05:07
if you have injury for larger organs?
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如果你有大一点的器官的损伤呢？
05:10
What do we do when we have injuries
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我们该怎么做
05:12
for structures which are much larger
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当受伤的组织
05:14
than one centimeter?
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大于1厘米时？
05:16
Then we can start to use cells.
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我们可以使用细胞
05:19
The strategy here, is if a patient comes in to us
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现在战略是，如果一个病人向我们求诊
05:22
with a diseased or injured organ,
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他有得病或受伤的器官。
05:24
you can take a very small piece of tissue from that organ,
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你从那个器官上取下非常小的一块组织，
05:27
less than half the size of a postage stamp,
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比邮票的一半还小，
05:30
you can then tease that tissue apart,
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然后分离这块组织
05:33
and look at its basic components,
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研究它的基本成分，
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the patient's own cells,
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也就是这个病人自己的细胞。
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you take those cells out,
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你把这些细胞取出来
05:39
grow and expand those cells outside the body in large quantities,
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在身体外，进行大量繁殖，生长，
05:43
and then we then use scaffold materials.
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然后我们使用一种支架材料
05:46
To the naked eye they look like a piece of your blouse,
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用肉眼看，它们像你外套或衬衣的一块布。
05:49
or your shirt, but actually
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但事实上
05:51
these materials are fairly complex
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这些材料相当复杂。
05:54
and they are designed to degrade once inside the body.
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一旦植入身体，在数月后
05:57
It disintegrates a few months later.
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它们会降解。
05:59
It's acting only as a cell delivery vehicle.
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这就像是一个细胞运输机
06:02
It's bringing the cells into the body. It's allowing
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它把细胞带入到身体内。
06:04
the cells to regenerate new tissue,
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使细胞能创造新的组织
06:06
and once the tissue is regenerated the scaffold goes away.
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一旦组织形成，这个支架就会消失。
06:10
And that's what we did for this piece of muscle.
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这就是我们为这块肌肉进行的治疗。
06:13
This is actually showing a piece of muscle and how we go through
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这展示了一块肌肉，以及我们
06:15
the structures to actually engineer the muscle.
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怎么通过这些支架来建造肌肉。
06:18
We take the cells, we expand them,
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我们取出一些细胞，扩展他们
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we place the cells on the scaffold,
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我们把这些细胞放在一块支架上，
06:22
and we then place the scaffold back into the patient.
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然后把整个支架放回到病人体内。
06:25
But actually, before placing the scaffold into the patient,
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事实上，在我们把这块支架放在病人身体里之前，
06:28
we actually exercise it.
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我们要锻炼它。
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We want to make sure that we condition
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我们要保证我们
06:33
this muscle, so that it knows what to do
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教会肌肉，这样它就知道
06:35
once we put it into the patient.
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放进体内后要做什么。
06:37
That's what you're seeing here. You're seeing
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这就是你现在看到的情况。
06:39
this muscle bio-reactor
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你看，这是肌肉生物反应装置，
06:41
actually exercising the muscle back and forth.
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它在让肌肉做前后拉伸练习。
06:45
Okay. These are flat structures that we see here,
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好的。那些就是我们现在看到的平面结构
06:49
the muscle.
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肌肉
06:51
What about other structures?
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那其他结构呢？
06:53
This is actually an engineered blood vessel.
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这是一个人造的血管
06:56
Very similar to what we just did, but a little bit more complex.
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非常类似于刚才的情况，但更复杂
06:59
Here we take a scaffold,
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现在我们有一个基底材料
07:01
and we basically -- scaffold can be like a piece of paper here.
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基本上我们--这里基底材料可以像一张纸
07:05
And we can then tubularize this scaffold.
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然后我们能把它做成管状
07:07
And what we do is we, to make a blood vessel, same strategy.
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我们用同样的战略来造一根血管。
07:11
A blood vessel is made up of two different cell types.
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血管由两种不同的细胞组成
07:15
We take muscle cells, we paste,
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我们取下肌肉细胞，进行粘贴，
07:18
or coat the outside with these muscle cells,
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或把细胞涂在外部。
07:20
very much like baking a layer cake, if you will.
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非常像制作一层蛋糕。
07:23
You place the muscle cells on the outside.
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你把肌肉细胞植在外部，
07:26
You place the vascular blood vessel lining cells on the inside.
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你把血管细胞植在里面。
07:31
You now have your fully seeded scaffold.
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现在你就有一个内外都植入细胞的基底材料。
07:33
You're going to place this in an oven-like device.
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接下来，把它放在一个像烤箱的设备里。
07:36
It has the same conditions as a human body,
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它的环境跟人体类似：
07:38
37 degrees centigrade,
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37度
07:40
95 percent oxygen.
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95％的氧气。
07:42
You then exercise it, as what you saw on that tape.
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然后让它练习，就像你在那个录像里看到的一样
07:46
And on the right you actually see a carotid artery that was engineered.
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在右边，你看到的是一个造好的颈动脉
07:49
This is actually the artery that goes from your neck to your brain.
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它是从颈部延伸到脑部的血管。
07:52
And this is an X-ray showing you
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这张X光片给你展示了
07:55
the patent, functional blood vessel.
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一个病人的健全的血管
07:58
More complex structures
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更复杂的结构
08:00
such as blood vessels, urethras, which I showed you,
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比如我之前给你们看的血管，尿道
08:03
they're definitely more complex
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他们绝对更复杂
08:05
because you're introducing two different cell types.
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因为你要引进两种不同的细胞
08:07
But they are really acting mostly as conduits.
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但大部分时候，他们真的像管道一样运行
08:09
You're allowing fluid or air to go through
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你要允许液体，气体通过
08:11
at steady states.
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并要稳定的速度。
08:13
They are not nearly as complex as hollow organs.
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他们远没有中空器官复杂。
08:15
Hollow organs have a much higher degree of complexity,
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中空器官更加复杂，
08:18
because you're asking these organs to act on demand.
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因为那些器官要根据要求来工作。
08:21
So, the bladder is one such organ.
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而膀胱就是这种器官。
08:24
Same strategy, we take a very small piece of the bladder,
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用同样的战略，我们取下膀胱的一小片组织
08:27
less than half the size of a postage stamp.
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比邮票的一半还小
08:29
We then tease the tissue apart
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然后我们把这片组织分解成
08:31
into its two individual cell components,
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两个独立的细胞成分
08:33
muscle, and these bladder specialized cells.
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肌肉以及那些膀胱特有的细胞
08:36
We grow the cells outside the body in large quantities.
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在体外，大量培植那些细胞
08:39
It takes about four weeks to grow these cells from the organ.
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它们的生长大约需4周时间
08:42
We then take a scaffold that we shape like a bladder.
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然后我们用一个智能材料，做成膀胱形状
08:45
We coat the inside with these bladder lining cells.
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在内部，我们把衬细胞植入
08:49
We coat the outside with these muscle cells.
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在外部，我们植入肌肉细胞
08:52
We place it back into this oven-like device.
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我们把它放回到这个像烤箱一样的装置
08:55
From the time you take that piece of tissue, six to eight weeks later
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在你取下这片组织的6到8周后
08:58
you can put the organ right back into the patient.
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你就能把器官植入到病人体中
09:01
This actually shows the scaffold.
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这展示了智能材料
09:04
The material is actually being coated with the cells.
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这个材料外部布满了细胞
09:08
When we did the first clinical trial for these patients
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我们对病人进行第一次临床试验
09:11
we actually created the scaffold specifically for each patient.
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我们为每个病人制造特殊的智能材料。
09:14
We brought patients in,
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我们让病人来医院，
09:16
six to eight weeks prior to their scheduled surgery, did X-rays,
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在他们手术日期前的6到8周，进行X光检查
09:19
and we then composed a scaffold specifically for that patient's size
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然后我们制造符合该病人尺寸的特殊材料
09:22
pelvic cavity.
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根据他们的盆腔尺寸。
09:24
For the second phase of the trials
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试验的第二阶段
09:26
we just had different sizes, small, medium, large and extra-large.
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我们就只是预备了不同的型号，小号，中号，大号，特大
09:29
(Laughter)
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（笑）
09:32
It's true.
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真的。
09:34
And I'm sure everyone here wanted an extra-large. Right?
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我想大家都想要加大号，是吧？
09:37
(Laughter)
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（笑）
09:39
So, bladders are definitely a little bit more complex
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所以，膀胱肯定比其它结构
09:42
than the other structures.
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更复杂。
09:44
But there are other hollow organs that have added complexity to it.
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但现在有一些中空器官复杂性更多。
09:47
This is actually a heart valve, which we engineered.
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这是我们制造出的一个心脏瓣膜
09:50
And the way you engineer this heart valve is the same strategy.
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我们用同样的战略制造这个心瓣膜。
09:53
We take the scaffold, we seed it with cells,
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我们有智能材料，我们植入细胞，
09:55
and you can now see here, the valve leaflets opening and closing.
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你看，这些瓣膜小叶正一开一合。
09:59
We exercise these prior to implantation.
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在植入人体前，这些材料会得到锻炼，
10:02
Same strategy.
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同样的战略
10:04
And then the most complex are the solid organs.
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最复杂的是实质器官
10:06
For solid organs, they're more complex
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实质器官更复杂
10:08
because you're using a lot more cells per centimeter.
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因为他们每厘米使用的器官更多
10:12
This is actually a simple solid organ like the ear.
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这是一个简单的实质器官，像耳朵
10:14
It's now being seeded with cartilage.
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现在植入了软骨
10:16
That's the oven-like device;
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那是那个像烤箱一样的装置
10:19
once it's coated it gets placed there.
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植入细胞后，我们就把整个材料放入其中，
10:21
And then a few weeks later we can take out the cartilage scaffold.
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数周后，我们就能取出这个特殊材料。
10:26
This is actually digits that we're engineering.
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这记录了我们的制造过程，
10:28
These are being layered, one layer at a time,
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我们植入很多层，一次一层，
10:31
first the bone, we fill in the gaps with cartilage.
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首先是骨头，我们在缝隙中填入软骨。
10:34
We then start adding the muscle on top.
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在上面，我们植入肌肉。
10:36
And you start layering these solid structures.
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然后你可以开始一层层的建成一个实体结构，
10:38
Again, fairly more complex organs,
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得到更复杂的器官。
10:41
but by far, the most complex solid organs
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但到目前为止，最复杂的实体器官是
10:44
are actually the vascularized, highly vascularized,
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是包含很多血管的实体器官。
10:48
a lot of blood vessel supply,
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器官连接很多血管的，
10:50
organs such as the heart,
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比如心脏，
10:53
the liver, the kidneys.
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肝脏，肾脏。
10:56
This is actually an example -- several strategies
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这是一个例子——我们有很多战略
10:58
to engineer solid organs.
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来制造实体器官
11:00
This is actually one of the strategies. We use a printer.
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这是其中之一。我们使用一个打印机
11:02
And instead of using ink, we use -- you just saw an inkjet cartridge --
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不使用墨水，我们使用——你刚看到，而我们的墨盒
11:06
we just use cells.
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是细胞
11:08
This is actually your typical desktop printer.
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这就是你典型的电脑打印机
11:10
It's actually printing this two chamber heart,
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它实际上打印出了两个心室
11:13
one layer at a time.
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一次一层
11:15
You see the heart coming out there. It takes about 40 minutes to print,
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你看现在印出了一颗心，这大概需要40分钟时间
11:19
and about four to six hours later
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大约6小时之后，
11:21
you see the muscle cells contract.
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你看那些肌肉细胞在收缩。
11:24
(Applause)
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（鼓掌）
11:30
This technology was developed by Tao Ju, who worked at our institute.
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这项科技的发明者是Tao Ju,他在我们研究所工作。
11:34
And this is actually still, of course, experimental,
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当然，这现在还处在试验阶段，
11:36
not for use in patients.
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还未运用到病人身上。
11:39
Another strategy that we have followed
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我们发明的另外一项战术，
11:41
is actually to use decellularized organs.
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是使用去细胞的器官。
11:43
We actually take donor organs,
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我们接受捐赠者器官，
11:46
organs that are discarded,
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不再使用的器官
11:48
and we then can use very mild detergents
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然后我们用非常柔和的洗涤剂，
11:50
to take all the cell elements out of these organs.
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把那些器官的细胞都洗掉。
11:53
So, for example on the left panel,
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比如，在左边的图上，
11:55
top panel, you see a liver.
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上面的图，你会看见一个肝脏。
11:57
We actually take the donor liver,
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我们接受捐赠的肝脏，
11:59
we use very mild detergents,
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然后，使用温和清洁剂，
12:01
and we, by using these mild detergents, we take all the cells
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我们用这些温和清洁剂，可洗掉所有
12:05
out of the liver.
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肝脏的细胞。
12:07
Two weeks later, we basically can lift this organ up,
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两周后，我们可拿起这个器官，
12:10
it feels like a liver,
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它感觉像肝脏，
12:12
we can hold it like a liver,
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拿起来，感觉也像肝脏，
12:14
it looks like a liver, but it has no cells.
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看起来，也像肝脏，但是它没有细胞，
12:17
All we are left with
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剩下的
12:19
is the skeleton, if you will, of the liver,
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是肝脏的架子，
12:22
all made up of collagen,
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由胶原蛋白组成。
12:24
a material that's in our bodies, that will not reject.
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这是我们体内的一种物质，不会有排异，
12:26
We can use it from one patient to the next.
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我们就可以把它使用到不同病人身上。
12:28
We then take this vascular structure
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然后我们拿来这个血管化的结构，
12:30
and we can prove that we retain the blood vessel supply.
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我们能证明我们保持了血管供应。
12:34
You can see, actually that's a fluoroscopy.
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你看，这实际上是荧光显影术。
12:36
We're actually injecting contrast into the organ.
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实际上，我们注射显影剂到器官里
12:39
Now you can see it start. We're injecting the contrast into the organ
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你看，这是开始。我们正注射显影剂到器官，
12:43
into this decellularized liver.
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到这个去细胞化的肝脏。
12:45
And you can see the vascular tree that remains intact.
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你可以看到这整个管道结构没受影响。
12:48
We then take the cells, the vascular cells,
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然后我们用细胞，管道细胞
12:51
blood vessel cells, we perfuse the vascular tree
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血管细胞，我们用病人自己的细胞
12:53
with the patient's own cells.
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注满这个树状的血管。
12:55
We perfuse the outside of the liver
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我们在肝脏外注满
12:57
with the patient's own liver cells.
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病人自己的肝脏细胞。
12:59
And we can then create functional livers.
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然后我们就创造了一个有功能的肝脏。
13:01
And that's actually what you're seeing.
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这就是你现在看到的。
13:03
This is still experimental. But we are able to actually reproduce the functionality
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这还只是实验。但我们已经能够恢复这个肝脏的功能，
13:07
of the liver structure, experimentally.
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尽管是实验阶段。
13:10
For the kidney,
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而肾脏，
13:12
as I talked to you about the first painting that you saw,
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记得我一开始给你看的那幅画，
13:16
the first slide I showed you,
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和我展示的第一张幻灯片。
13:18
90 percent of the patients on the transplant wait list
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90％在等待器官移植的病人，
13:21
are waiting for a kidney, 90 percent.
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90％都在等待肾脏移植。
13:23
So, another strategy we're following
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所以，我们还有另外一个战术
13:25
is actually to create wafers
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那就是创造薄片
13:27
that we stack together, like an accordion, if you will.
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我们把他们堆积在一起，像手风琴一样
13:31
So, we stack these wafers together, using the kidney cells.
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所以，我们把那些薄片堆积在一起，使用肾脏细胞
13:34
And then you can see these miniature kidneys that we've engineered.
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然后，你能看到我们制造出的迷你版的肾脏，
13:37
They are actually making urine.
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他们真的可以产生尿液。
13:39
Again, small structures, our challenge is how to make them larger,
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但这还是小的结构，我们的挑战还是怎么样把他们变大。
13:43
and that is something we're working on
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这就是我们现在在研究所
13:45
right now at the institute.
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研究的事情。
13:47
One of the things that I wanted to summarize for you then
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我想给你们总结的一件事情是
13:50
is what is a strategy that we're going for in regenerative medicine.
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我们尝试向再生医学迈进所用的战略。
13:54
If at all possible,
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如果都可能的话
13:56
we really would like to use smart biomaterials
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我们希望使用智能生物材料。
13:59
that we can just take off the shelf
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我们只需从架子上取下来一个智能材料，
14:01
and regenerate your organs.
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就能重造你的器官。
14:03
We are limited with distances right now,
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我们现在重造的距离有限
14:05
but our goal is actually to increase those distances over time.
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但我们的目标是在未来扩大这个距离。
14:09
If we cannot use smart biomaterials,
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如果我们不能使用智能材料，
14:11
then we'd rather use your very own cells.
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那我们倾向使用您自己的细胞。
14:13
Why? Because they will not reject.
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为什么？因为它们不会有排斥反应。
14:15
We can take cells from you,
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我们可以从你身上取下细胞，
14:17
create the structure, put it right back into you, they will not reject.
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创造结构，放回到你的身体，他们不会有排斥反应。
14:20
And if possible, we'd rather use the cells from your very specific organ.
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如果可能，我们倾向于使用你同一个器官的细胞。
14:24
If you present with a diseased wind pipe
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如果你气管有病，
14:27
we'd like to take cells from your windpipe.
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我们希望从你的气管取下细胞。
14:29
If you present with a diseased pancreas
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如果你的胰腺有病，
14:32
we'd like to take cells from that organ.
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我们希望从它上面取细胞。
14:34
Why? Because we'd rather take those cells
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为什么？因为我们宁愿取那些细胞，
14:37
which already know that those are the cell types you want.
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是已经知道是你的身体需要的那种细胞的。
14:40
A windpipe cell already knows it's a windpipe cell.
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一个气管的细胞知道什么是气管细胞，
14:43
We don't need to teach it to become another cell type.
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我们不用教它变成另一种细胞。
14:46
So, we prefer organ-specific cells.
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所以，我们倾向于你的某个器官的细胞。
14:48
And today we can obtain cells from most every organ in your body,
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今天，我们可以从差不多所有器官上取下细胞，
14:51
except for several which we still need stem cells for,
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除了几个例外，（这几个）我们还需要它们的干细胞。
14:54
like heart, liver, nerve and pancreas.
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比如心脏，肝脏，神经及胰腺。
14:58
And for those we still need stem cells.
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对于那些我们还需要干细胞的，
15:01
If we cannot use stem cells from your body
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如果我们不能使用你身体的干细胞，
15:04
then we'd like to use donor stem cells.
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那我们就要使用捐赠者的干细胞。
15:07
And we prefer cells that will not reject
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我们倾向于不会有排斥反应的细胞，
15:09
and will not form tumors.
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并且不会形成肿瘤的细胞。
15:11
And we're working a lot with the stem cells that we
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我们正大力研究干细胞。
15:13
published on two years ago,
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这些结果两年前发表了。
15:15
stem cells from the amniotic fluid,
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他们是来自于羊水
15:17
and the placenta, which have those properties.
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和胎盘的干细胞。
15:21
So, at this point, I do want to tell you that
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现在，我想告诉你们
15:24
some of the major challenges we have.
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我们现在面临的主要挑战。
15:28
You know, I just showed you this presentation, everything looks so good,
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你知道，我刚给你们做的演讲，看起来非常好，
15:30
everything works. Actually no,
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每个环节都很好。事实并非如此。
15:32
these technologies really are not that easy.
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那些科技并不是那么简单。
15:34
Some of the work you saw today
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你今天看到的一部分，
15:36
was performed by over 700 researchers
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3000
是我们研究所超过700个研究人员，
15:39
at our institute across a 20-year time span.
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历时20年的研究成果。
15:42
So, these are very tough technologies.
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所以，这些是非常难的科技。
15:44
Once you get the formula right you can replicate it.
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一旦你摸索出了对的方法，你就能进行器官复制。
15:47
But it takes a lot to get there.
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但这需要很多工作（才能摸索出对的方法）。
15:49
So, I always like to show this cartoon.
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所以，我总是给大家看这个卡通
15:51
This is how to stop a runaway stage.
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这展示了怎么样阻止一个失控的车。
15:53
And there you see the stagecoach driver,
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你看到这个巴士的司机
15:55
and he goes, on the top panel,
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上面的图里
15:57
He goes A, B, C, D, E, F.
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他做了A,B,C,D,E,F，
15:59
He finally stops the runaway stage.
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他终于停下了失控的车
16:01
And those are usually the basic scientists,
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这是最基本的科学研究方法。
16:04
The bottom is usually the surgeons.
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下面的是外科医生
16:06
(Laughter)
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（笑）
16:10
I'm a surgeon so that's not that funny.
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我是个医生，所以不是那么好笑。
16:12
(Laughter)
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（笑）
16:13
But actually method A is the correct approach.
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事实上方法A是正确的方法。
16:17
And what I mean by that is that anytime we've launched one of these technologies
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我的意思是我们任何时候把这样的科技
16:20
to the clinic,
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用于临床，
16:22
we've made absolutely sure that we do everything we can
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我们要绝对确保把这些科技运用到病人之前，
16:25
in the laboratory before we ever
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我们在实验室里尽了全力
16:27
launch these technologies to patients.
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保证这种科技的安全性。
16:29
And when we launch these technologies to patients
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当我们运用到病人身上时
16:31
we want to make sure that we ask ourselves a very tough question.
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我们要确保问了自己一个非常严肃的问题：
16:36
Are you ready to place this in your own loved one, your own child,
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你是否觉得这个可以移植到你爱的人，你自己的小孩，
16:39
your own family member, and then we proceed.
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你的家人身上，然后我们再继续。
16:42
Because our main goal, of course,
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因为我们的首要目标，
16:44
is first, to do no harm.
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是不造成任何伤害。
16:47
I'm going to show you now, a very short clip,
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我现在给你们看一个短片，
16:49
It's a five second clip of a patient
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一个病人的5秒钟短片。
16:52
who received one of the engineered organs.
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她接受了我们制造的器官。
16:54
We started implanting some of these structures
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在14年前，我们就开始
16:56
over 14 years ago.
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移植这些器官。
16:58
So, we have patients now walking around with organs,
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所以，我们现在有生活着的接受了我们器官的病人。
17:00
engineered organs, for over 10 years, as well.
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有的时间已经超过10年。
17:04
I'm going to show a clip of one young lady.
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我给你们看一个年轻女性的短片
17:06
She had a spina bifida defect, a spinal cord abnormality.
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她有先天的脊椎裂，一种脊椎异常。
17:09
She did not have a normal bladder. This is a segment from CNN.
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她本来也没有正常的膀胱。这是CNN的一段录像。
17:12
We are just taking five seconds.
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我们只看5秒。
17:14
This is a segment that Sanjay Gupta actually took care of.
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这部分是Sanjay Gupta录的。
17:19
Video: Kaitlyn M: I'm happy. I was always afraid
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录像：Kaitlyn M:我很高兴。我总是害怕
17:21
that I was going to have like, an accident or something.
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我会出事什么的。
17:24
And now I can just go and
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现在我能走，
17:27
go out with my friends,
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能跟我的朋友出去，
17:29
go do whatever I want.
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做我想做的事情。
17:32
Anthony Atala: See, at the end of the day, the promise of regenerative medicine
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Anthony Atala: 说到底，器官再生的诺言
17:35
is a single promise.
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是一个诺言
17:37
And that is really very simple,
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而且非常简单：
17:40
to make our patients better.
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就是让我们的病人更好
17:42
Thank you for your attention.
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谢谢你们的倾听。
17:44
(Applause)
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（鼓掌）
ABOUT THE SPEAKER
Anthony Atala - SurgeonAnthony Atala asks, "Can we grow organs instead of transplanting them?" His lab at the Wake Forest Institute for Regenerative Medicine is doing just that -- engineering over 30 tissues and whole organs.
Why you should listen
Anthony Atala is the director of the Wake Forest Institute for Regenerative Medicine, where his work focuses on growing and regenerating tissues and organs. His team engineered the first lab-grown organ to be implanted into a human -- a bladder -- and is developing experimental fabrication technology that can "print" human tissue on demand.
In 2007, Atala and a team of Harvard University researchers showed that stem cells can be harvested from the amniotic fluid of pregnant women. This and other breakthroughs in the development of smart bio-materials and tissue fabrication technology promises to revolutionize the practice of medicine.
Anthony Atala | Speaker | TED.com