TRANSPLANTS The Gift of Life. Boris L. Gala-Lopez. MD, MSc, PhD Multi-Organ Transplant Surgeon

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1 TRANSPLANTS The Gift of Life Boris L. Gala-Lopez. MD, MSc, PhD Multi-Organ Transplant Surgeon

2 Disclosure I, Boris Gala-Lopez declare that in the past 3 years: I have received manufacturer funding from the following companies*: No I have done consulting work for the following companies*: No I have done speaking engagements for the following companies*: None I or my family hold individual shares in the following*: None *pharmaceutical or medical/dental equipment

3 Trans plant Move or transfer (something) to another place or situation, typically with some effort or upheaval. "his endeavor to transplant people from Russia to the Argentine" synonyms: transfer, move, remove, shift, relocate, take "our headquarters will be transplanted to Pennsylvania" Replant (a plant) in another place. synonyms: replant, repot, relocate "the seedlings should be transplanted in larger pots" Remove (living tissue or an organ) and implant it in another part of the body or in another body. synonyms: transfer, implant "kidneys must be transplanted within 48 hours of removal"

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6 THE HISTORY OF TRANSPLANTS First successful kidney transplant operation in Credit: Brigham and Women's Hospital, via Associated Press. The New York Times Nov 27, 2012.

7 THE HISTORY OF TRANSPLANTS 1668 First successful bone transplant 1818 First successful blood transfusion 1881 First skin graft 1900 Discovery of blood group types 1902 Discovery of technique for connecting blood vessels 1905 First successful cornea transplant 1908 First knee transplant

8 THE HISTORY OF TRANSPLANTS 1954 First successful kidney transplant 1963 First successful lung transplant 1966 First successful pancreas transplant 1967 First successful liver transplant 1967 First successful heart transplant 1968 First organ donor program established 1970s Researchers refine knowledge about tissue typing and immune response 1970s Discovery of new immunosuppression drugs 1973 First successful bone marrow transplant 1988 First successful small bowel transplant 1989 First successful living donor liver transplant 1998 First successful hand transplant 2005 First successful face transplant

9 Organ and Tissue Donation Rebirth 2017

10 Types of Donors Brain Dead: (DBD or NDD) Can donate organs and tissue Donation after Cardiac Death: (DCD) Can donate organs and tissue Living Donor: Can donate some organs and tissue

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13 Organ Donation in Canada

14 March 2016 Canadian organ donations fall short of meeting demand: report

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16 Expanding the Organ Donor Pool Developing new strategies to use suboptimal organs and tissue Advocating for safe living donation with new concepts Increasing translational research to safely implement bioengineered organs and tissue into medical practice

17 Expanding the Organ Donor Pool Developing new strategies to use suboptimal organs and tissue Advocating for safe living donation with new concepts Increasing translational research to safely implement bioengineered organs and tissue into medical practice

18 Expanding the Organ Donor Pool Using Suboptimal Organs Courtesy: Dr. J. Shapiro Quick, Cheap, Practical Standard for 40 years Metabolism 12-fold less, but not zero Ischemic - no O2

19 Expanding the Organ Donor Pool Using Suboptimal Organs

20 Expanding the Organ Donor Pool Using Suboptimal Organs

21 The Rise of the Machines LifePort TransMedics OrganOx Metra Ex Vivo Metrics Tevosol

22 Feb

23 Expanding the Organ Donor Pool Developing new strategies to use suboptimal organs and tissue Advocating for safe living donation with new concepts Increasing translational research to safely implement bioengineered organs and tissue into medical practice

24 Expanding the Organ Donor Pool Safer Living Donation with New Concepts University of Illinois at Chicago. Department of Surgery

25 Sasaki et al. Clin Transpl 2010

26 Expanding the Organ Donor Pool Safer Living Donation with New Concepts Kidney Paired Donation Program University Health Network

27 Expanding the Organ Donor Pool Safer Living Donation with New Concepts Kidney Paired Donation Program University Health Network

28 Expanding the Organ Donor Pool Developing new strategies to use suboptimal organs and tissue Advocating for safe living donation with new concepts Increasing translational research to safely implement bioengineered organs and tissue into medical practice

29 Expanding the Organ Donor Pool Bioengineering Organ and Tissue Should we redesign humans?

30 Expanding the Organ Donor Pool Bioengineering Organ and Tissue

31 Expanding the Organ Donor Pool Bioengineering Organ and Tissue Tissue engineering: How to build a heart

32 Getting under the skin: UAlberta research reveals new possibilities for islet and stem cell transplantation University of Alberta, April 2015 Cure for diabetes could lie in tiny device; Alberta researchers looking for volunteers December 2015

33 The Future of Transplants

34 Science Fact!! Simultaneous machine preservation of: Lungs, liver, two kidneys

35 The New York Times, Oct 2016

36 Tonic, March 2017

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39 Take-home message Transplantation is a valuable treatment modality for selected patients with organ failure This therapy has truly enforce the concept of multidisciplinary collaboration The implementation of transplants has become one of the most important revolutions in the field of medicine Research and development will be the key players in the future of transplantation

40 THANK YOU!