Daniel Kraft invents a better way to harvest bone marrow

譯者: Mandy Lo 審譯者: Bill Hsiung

So I am a pediatric cancer doctor

我是一個小兒科癌病醫師，

and stem-cell researcher at Stanford University

亦在史丹佛大學研究幹細胞，

where my clinical focus has been bone marrow transplantation.

我的臨床研究專攻骨髓移植。

Now, inspired by Jill Bolte Taylor last year,

我受到去年 TED 講者 Jill Bolte Taylor 的影響，

I didn't bring a human brain,

雖然我沒有帶一個人腦標本來，

but I did bring a liter of bone marrow.

但我帶了一公升的骨髓。

And bone marrow is actually what we use

我們就是用這些骨髓，

to save the lives of tens of thousands of patients,

拯救了數萬名病人的生命，

most of whom have advanced malignancies like leukemia and lymphoma

他們大部分患有較嚴重的惡性腫瘤，如血癌與淋巴瘤

and some other diseases.

和其他一些疾病。

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

回想數年前，我在史丹佛學習手術移植時，

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

我在手術房， 還有 Bob ，

who is a volunteer donor.

Bob 是名器官志願捐贈者。

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

他的骨髓被運送橫跨了整個國家， 拯救了一個

of a child with leukemia.

患了血癌的小孩。

So actually how do we harvest this bone marrow?

我們怎樣抽取這些骨髓呢？

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

我們有一整個手術醫療團隊，麻醉醫師， 護士，

and another doctor across from me.

我對面還站著另一位醫師。

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

Bob 躺在桌上，然後我們將這個針筒，

you know, not too big.

這針筒並不是太大。

And the way we do this is we basically

基本上，我們用的方法是

place this through the soft tissue,

將這針筒放進軟組織，

and kind of punch it into the hard bone,

鑽入硬骨頭，

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

插入 tuchus （這是屁股的專業術語），

and aspirate about 10 mls of bone marrow out,

每一次用針筒

each time, with a syringe.

吸出大概十毫升骨髓，

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

然後把針筒傳給護士，她把骨髓注入一個鐵桶，

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

再將針筒傳給我。如此這般，不斷的重複，

About 200 times usually.

大約二百次。

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

到最後，我的手臂酸痛，手掌長繭。

let alone Bob,

更不用說 Bob 了！

whose rear end looks something more like this,

他的屁股就像這幅圖一樣，

like Swiss cheese.

像個瑞士起司。

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

所以我就在想，你知道的，這方法四十年來沒有任何改變，

And there is probably a better way to do this.

應該可以有更好的方法。

So I thought of a minimally invasive approach,

因此，我想出一個減少侵入身體的方法。

and a new device that we call the Marrow Miner.

一個叫做「骨髓採取器」的新儀器就此誕生。

This is it.

就是這個。

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

「骨髓採取器」的用法示範如下，

Our standard see-through patient.

看看這個可以被「看穿」的病人 ...

Instead of entering the bone dozens of times,

相對於鑽入骨頭數十次，

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

我們只需要從臀部前面或後面鑽一次。

And we have a flexible, powered catheter

將這條柔軟的電動導管 —

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

其管尖上有一個可留在骨髓內的特別鋼圈，

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

它能隨著臀部的輪廓移動。

So it enables you to very rapidly aspirate,

這機器能讓你從同一個洞，

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

快速的大量吸取骨髓。

We can do multiple passes through that same entry.

我們可以利用同一個入口多次進出，

No robots required.

無需機械人輔助。

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

非常迅速地，Bob 只需一個傷口，局部麻醉，

and do this harvest as an outpatient.

可將他當作一般的門診病人辦理。

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

因此我做了幾個原型，在史丹佛申請了一個小額研究贊助金。

And played around with this a little bit.

繼續探究這個方法的可行性。

And our team members developed this technology.

我們團隊的成員開發了這項技術。

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

結果完成兩項用大型動物及豬作試驗的研究項目。

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

我們發現這個方法不但可以取得骨髓,

but we got 10 times the stem cell activity

而且用「骨髓採取器」所抽出的骨髓比使用舊有方法抽出的骨髓

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

幹細胞活性增加十倍。

This device was just FDA approved in the last year.

這個儀器去年剛剛被美國食品及藥物管理局批准使用。

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

從這個真實病人的片段，你可以看到管子隨著弧線移動。

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

在同一個病人，同一個位置，進入兩次。

This was done under local anesthesia, as an outpatient.

只需局部麻醉，因此病人掛門診即可。

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

比起原來標準的方法，同一個病人，

than the standard approach done on the same patient.

可以取出三至六倍的幹細胞。

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

為什麼這很重要？骨髓內充滿著成人幹細胞，

You all know about embryonic stem cells.

相信你們都聽過胚胎幹細胞,

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

它們潛力無窮，但還未進入臨床試驗階段。

Adult stem cells are throughout our body,

但成人幹細胞遍佈我們身體各處,

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

包括在骨髓製造血液的幹細胞。

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

骨髓移植其實就是一種幹細胞療法，

for over 40 years.

這療法我們已經進行了四十餘年。

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

過去十年，利用骨髓幹細胞

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

治療各種疾病的應用層出不窮，

such as heart disease, vascular disease,

如心臟病、血管疾病、

orthopedics, tissue engineering,

整型外科、組織工程

even in neurology to treat Parkinson's

及腦科疾病，如帕金森氏症,

and diabetes.

和糖尿病。

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

今年，我們剛剛公佈，正在推廣

generation 2.0 of the Marrow Miner.

第二代「骨髓採取器」。

The hope is that this gets more stem cells out,

希望可以取出更多幹細胞，

which translates to better outcomes.

令更多病人康復。

It may encourage more people to sign up to be

同時也可能會鼓勵更多人登記成為

potential live-saving bone marrow donors.

能拯救生命的骨髓捐贈者。

It may even enable you to bank

甚至可能讓你

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

趁你年輕力壯時，儲存你自己的骨髓幹細胞,

to use in the future should you need it.

以備未來不時之需。

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

最後 — 這是一張我們

bone marrow transplant survivors,

骨髓移植康復者的合照。

who come together for a reunion each year at Stanford.

他們每年都會回到史丹佛聚會。

Hopefully this technology will let us

希望這項技術可以讓我們

have more of these survivors in the future.

未來參加聚會的康復者人數愈來愈多。

Thanks.

謝謝

(Applause)

（掌聲）