Daniel Kraft invents a better way to harvest bone marrow

Prevodilac: Jelena Nedjic Lektor: Ana Zivanovic-Nenadovic

So I am a pediatric cancer doctor

Ja sam dečiji onkolog,

and stem-cell researcher at Stanford University

i bavim se istraživanjem matičnih ćelija na Univerzitetu Stanford,

where my clinical focus has been bone marrow transplantation.

a glavna tema mojih istraživanja jeste transplantacija koštane srži.

Now, inspired by Jill Bolte Taylor last year,

Inspirisan prošlogodišnjim govorom Džil Bolt Tejlor,

I didn't bring a human brain,

nisam doneo ljudski mozak,

but I did bring a liter of bone marrow.

već litar koštane srži.

And bone marrow is actually what we use

Koristimo koštanu srž kako bismo

to save the lives of tens of thousands of patients,

spasili živote desetina hiljada pacijenata,

most of whom have advanced malignancies like leukemia and lymphoma

od kojih većina boluje od odmaklih malignih oboljenja

and some other diseases.

kao što su leukemija i limfoma, kao i neke druge bolesti.

So, a few years ago, I'm doing my transplant fellowship at Stanford.

Pre nekoliko godina sam radio svoju specijalizaciju

u oblasti transplantacije na Stanfordu.

I'm in the operating room. We have Bob here,

Nalazim se u operacionoj sali.

who is a volunteer donor.

Tamo je i Bob, donor-volonter.

We're sending his marrow across the country to save the life

Šaljemo ga po celoj državi da spašava živote

of a child with leukemia.

dece koja boluju od leukemije.

So actually how do we harvest this bone marrow?

Pa, kako mi u stvari sakupljamo koštanu srž?

Well we have a whole O.R. team, general anesthesia, nurses,

Imamo ceo tim za operacije, opšteg anesteziologa, medicinske sestre

and another doctor across from me.

i još jednog lekara preko puta mene.

Bob's on the table, and we take this sort of small needle,

Bob je na operacionom stolu, a mi uzmemo malu iglu,

you know, not too big.

znate već, ne baš preveliku.

And the way we do this is we basically

Uradimo proceduru tako što je u principu

place this through the soft tissue,

probijemo kroz meko tkivo,

and kind of punch it into the hard bone,

i zabodemo je u tvrdu kost,

into the tuchus -- that's a technical term --

u tuhus - to je tehnički izraz -

and aspirate about 10 mls of bone marrow out,

i izvučemo oko 10 ml koštane srži,

each time, with a syringe.

svaki put kada zabodemo iglu.

And hand it off to the nurse. She squirts it into a tin.

Potom to predamo sestri. Ona isprazni sadržaj igle u posudu.

Hands it back to me. And we do that again and again.

Ponovo mi je doda. I onda mi to radimo nanovo i nanovo,

About 200 times usually.

uglavnom oko 200 puta.

And by the end of this my arm is sore, I've got a callus on my hand,

Kada završimo proceduru mene boli ruka, izašao mi je žulj,

let alone Bob,

a da vam ne pričam o Bobu

whose rear end looks something more like this,

čija zadnjica i izgleda otprilike ovako,

like Swiss cheese.

kao švajcarski sir.

So I'm thinking, you know, this procedure hasn't changed in about 40 years.

Tada sam pomislio, znate, ova procedura se nije promenila u poslednjih 40 godina.

And there is probably a better way to do this.

Siguran sam da postoji bolji način da se to uradi.

So I thought of a minimally invasive approach,

Počeo sam da razmišljam o minimalno invazivnoj proceduri

and a new device that we call the Marrow Miner.

i novom uređaju koji zovemo Tučak koštane srži.

This is it.

To je ovo.

And the Marrow Miner, the way it works is shown here.

Način na koji Tučak koštane srži radi je pokazan ovde.

Our standard see-through patient.

Ovo je naš uobičajeni pacijent.

Instead of entering the bone dozens of times,

Umesto da probadamo kost desetinama puta,

we enter just once, into the front of the hip or the back of the hip.

samo jednom probodemo kost, sa prednje ili zadnje strane kuka.

And we have a flexible, powered catheter

Uređaj ima fleksibilan kateter koji radi na baterije,

with a special wire loop tip that stays inside the crunchy part of the marrow

i špatulicu od žice na vrhu koja zadire u hrskavi deo srži

and follows the contours of the hip, as it moves around.

i dok se pomera, prati linije kuka.

So it enables you to very rapidly aspirate,

Ovo vam omogućava da veoma brzo aspirirate,

or suck out, rich bone marrow very quickly through one hole.

ili izvučete bogatu koštanu srž kroz jednu rupu.

We can do multiple passes through that same entry.

Možemo nekoliko puta da prođemo kroz isti ulaz u kost.

No robots required.

Nisu nam potrebni roboti.

And, so, very quickly, Bob can just get one puncture, local anesthesia,

Tako da Bobu možemo dati samo lokalnu anesteziju,

probodemo njegovu kost jednom,

and do this harvest as an outpatient.

i uradimo ceo zahvat bez hospitalizacije.

So I did a few prototypes. I got a small little grant at Stanford.

Napravio sam nekoliko modela.

Dobio sam malu stipendiju za to na Stanfordu.

And played around with this a little bit.

Zanimao sam se ovim neko vreme.

And our team members developed this technology.

Članovi našeg tima su zajedno razvili ovu tehnologiju.

And eventually we got two large animals, and pig studies.

Na kraju smo došli do studija na svinjama i velikim životinjama.

And we found, to our surprise, that we not only got bone marrow out,

Na naše iznenađenje, pronašli smo da ne samo da uspevamo

but we got 10 times the stem cell activity

da izvučemo koštanu srž,

već da je ona 10 puta bogatija matičnim ćelijama,

in the marrow from the Marrow Miner, compared to the normal device.

This device was just FDA approved in the last year.

nego srž dobijena regularnim napravama.

Uređaj je prošle godine odobrila Agencija za hranu i lekove.

Here is a live patient. You can see it following the flexible curves around.

Ovo je stvarni pacijent.

There will be two passes here, in the same patient, from the same hole.

Vidite kako prati savitljive krivine unaokolo.

Napravićemo dva zahvata na istom pacijentu, kroz istu rupu.

This was done under local anesthesia, as an outpatient.

And we got, again, about three to six times more stem cells

Ovo je urađeno u lokalnoj anesteziji, bez hospitalizacije donora.

than the standard approach done on the same patient.

Ponovo smo dobili 3-6 puta više matičnih ćelija

u odnosu na standardnu proceduru na istom pacijentu.

So why should you care? Bone marrow is a very rich source of adult stem cells.

Zašto je ovo važno?

Koštana srž je veoma bogat izvor matičnih ćelija odraslih ljudi.

You all know about embryonic stem cells.

They've got great potential but haven't yet entered clinical trials.

Svi znate o embrionalnim, matičnim ćelijama.

U njima leži veliki potencijal,

Adult stem cells are throughout our body,

ali i ih dalje ne korisitmo u kliničkim istraživanjima.

including the blood-forming stem cells in our bone marrow,

which we've been using as a form of stem-cell therapy

Matične ćelije odraslih se nalaze u celom telu,

for over 40 years.

uključujući i ćelije od kojih nastaje krv u koštanoj srži,

In the last decade there's been an explosion of use

koje koristimo preko 40 godina kao vid terapije matičnim ćelijama.

of bone marrow stem cells to treat the patient's other diseases

U poslednjoj deceniji došlo je do procvata upotrebe

such as heart disease, vascular disease,

matičnih ćelija koštane srži u lečenju različitih bolesti

orthopedics, tissue engineering,

kao što su srčana bolest, bolest krvnih sudova,

even in neurology to treat Parkinson's

potom u ortopediji, u inženjeringu tkiva,

and diabetes.

a u neurologiji se čak koriste za lečenje Parkinsonove bolesti i dijabetesa.

We've just come out, we're commercializing, this year,

generation 2.0 of the Marrow Miner.

Upravo smo izbacili na tržište i ove godine komercijalizujemo

The hope is that this gets more stem cells out,

novu verziju Tučka koštane srži.

which translates to better outcomes.

Nadamo se da ćemo ovim putem doći do više matičnih ćelija

It may encourage more people to sign up to be

potential live-saving bone marrow donors.

što znači da ćemo imati bolje rezultate tretmana.

It may even enable you to bank

To može ohrabriti više ljudi da se registruju kao davaoci srži

your own marrow stem cells, when you're younger and healthier,

što potencijalno može spasiti živote ljudi.

to use in the future should you need it.

Može omogućiti da uskladištite

sopstvene matične ćelije dok ste mlađi i zdraviji,

And ultimately -- and here's a picture of our

bone marrow transplant survivors,

i koristite ih kasnije ako vam zatrebaju.

who come together for a reunion each year at Stanford.

Ovo je slika ljudi koji su preživeli

transplantacije koštane srži,

Hopefully this technology will let us

koji se svake godine okupe na Stanfordu.

have more of these survivors in the future.

Nadamo se da će nam ova tehnologija omogućiti

Thanks.

da povećamo broj uspešno izlečenih ljudi u budućnosti.

(Applause)

Hvala vam. (Aplauz)