Anthony Atala :培養新器官

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http://dotsub.com/view/7ca4ccf4-5eaf-4f3f-93e3-1129adb926da
Anthony Atala :培養新器官
这实际上是一幅画， 它挂在哈佛医学院Countway图书馆的墙上 记录了第一次器官移植。 在前面，你看，那是约翰.穆雷 正为病人做准备，接受移植 在房间后面，你会看见哈德威.哈罗孙 哈佛医学院泌尿科主任 正在摘除肾脏。 这个肾脏是第一个 移植到人体上的器官。
这发生在1954年 55年前， 那时他们正应对非常多挑战， 如同多年前一样。 当然有很多进步，拯救了很多生命， 但我们却非常缺乏器官。 在过去十年，等待移植的病人数量 已经翻倍， 但与此同时，移植的数量 却基本不变。 这主要是因为我们老龄化的人口。 我们正在变老。 医疗效果变好了， 使我们能活得更长。 但随着我们变老，器官也越来越容易生病
所以，这是一个挑战。 对于器官，组织都是如此。 试图替换胰腺， 试图替换神经，来帮助治疗帕金森综合症， 那些是主要的组织。 这事实上是非常惊人的数据， 每30秒钟 就有一个病人死于 可用替换组织治疗的疾病。 那，我们要怎么解决？ 今晚我们已谈论了干细胞 这是一个解决的办法。 但仍需方法把干细胞植入病人体中。 如果说我们要真（用干细胞）治疗（得病了的）器官。
若我们的身体能再生岂不是很好？ 若我们能管理身体的力量 来治愈自己，岂不是很好？ 事实上，这不是一个怪异的概念， 每天地球上都在发生。 这是火蜥蜴的一幅图片， 火蜥蜴就有这种自我再生的奇特能力。 请看这个小片段 这是火蜥蜴腿上受的伤 这是一幅真的图片， 按时间排列的照片，展示了受伤的腿 经过一段时间后再生的过程。 请看这个伤疤， 这个伤疤会长出来 一条新腿。
所以，火蜥蜴能做到再生。 为什么我们不能？为什么人类不能再生？ 事实上，我们可以再生。 你的身体有很多器官。 你身体的每一个器官， 都有一定数量的细胞 在你受伤时，会进行替代。这每天都在发生。 当你变老， 你的骨骼会每十年再生一次， 你的皮肤每两周再生一次。 所以，你的身体一直再进行着再生。 当受伤时，我们就有挑战了。 当受伤或生病时， 身体的第一个反应 是将这部分与身体其它部分隔离开 来抵抗感染。 进行治疗，你身体内的器官 或是你的皮肤，第一个反应 就是让伤疤组织行动 与外界进行隔离
那我们要怎么管理这种能力呢？ 方法之一是 使用智能生物材料 这是怎么生效的呢？在左边 是一个受伤的尿道 这是连接膀胱与身体外部的通道。 你看它已经受伤 基本上，我们发现你可以使用那些智能材料 （在受伤的地方）作为桥梁。 受伤的组织会（愈合然后） 与外部环境隔离开来， 有了这座桥梁， 你身体内再生的细胞 可以爬上这座桥，用它作为通道（来重建尿道）。
这就是你现在看到的事实 这实际上是一个智能生物材料。 我们使用它治好了这位病人。 这是在左边的一个受伤的尿道。 我们在中间使用智能材料， 6个月后，在右边， 你看这是再生的尿道。 其实我们的身体可以再生 但只能在小距离的情况下 再生细胞能走的最大距离 是1厘米。 所以，我们可以用这些智能材料 进行1厘米的再生 来治愈这些伤口
所以，我们可以再生，但只能短距离再生 我们怎么做才能（治疗病人） 如果你有大一点的器官的损伤呢？ 我们该怎么做 当受伤的组织 大于1厘米时？ 我们可以使用细胞 现在战略是，如果一个病人向我们求诊 他有得病或受伤的器官。 你从那个器官上取下非常小的一块组织， 比邮票的一半还小， 然后分离这块组织 研究它的基本成分， 也就是这个病人自己的细胞。 你把这些细胞取出来 在身体外，进行大量繁殖，生长， 然后我们使用一种支架材料
用肉眼看，它们像你外套或衬衣的一块布。 但事实上 这些材料相当复杂。 一旦植入身体，在数月后 它们会降解。 这就像是一个细胞运输机 它把细胞带入到身体内。 使细胞能创造新的组织 一旦组织形成，这个支架就会消失。
这就是我们为这块肌肉进行的治疗。 这展示了一块肌肉，以及我们 怎么通过这些支架来建造肌肉。 我们取出一些细胞，扩展他们 我们把这些细胞放在一块支架上， 然后把整个支架放回到病人体内。 事实上，在我们把这块支架放在病人身体里之前， 我们要锻炼它。 我们要保证我们 教会肌肉，这样它就知道 放进体内后要做什么。 这就是你现在看到的情况。 你看，这是肌肉生物反应装置， 它在让肌肉做前后拉伸练习。
好的。那些就是我们现在看到的平面结构 肌肉 那其他结构呢？ 这是一个人造的血管 非常类似于刚才的情况，但更复杂 现在我们有一个基底材料 基本上我们--这里基底材料可以像一张纸 然后我们能把它做成管状 我们用同样的战略来造一根血管。 血管由两种不同的细胞组成 我们取下肌肉细胞，进行粘贴， 或把细胞涂在外部。 非常像制作一层蛋糕。
你把肌肉细胞植在外部， 你把血管细胞植在里面。 现在你就有一个内外都植入细胞的基底材料。 接下来，把它放在一个像烤箱的设备里。 它的环境跟人体类似： 37度 95％的氧气。 然后让它练习，就像你在那个录像里看到的一样
在右边，你看到的是一个造好的颈动脉 它是从颈部延伸到脑部的血管。 这张X光片给你展示了 一个病人的健全的血管 更复杂的结构 比如我之前给你们看的血管，尿道 他们绝对更复杂 因为你要引进两种不同的细胞 但大部分时候，他们真的像管道一样运行 你要允许液体，气体通过 并要稳定的速度。 他们远没有中空器官复杂。 中空器官更加复杂， 因为那些器官要根据要求来工作。
而膀胱就是这种器官。 用同样的战略，我们取下膀胱的一小片组织 比邮票的一半还小 然后我们把这片组织分解成 两个独立的细胞成分 肌肉以及那些膀胱特有的细胞 在体外，大量培植那些细胞 它们的生长大约需4周时间 然后我们用一个智能材料，做成膀胱形状 在内部，我们把衬细胞植入 在外部，我们植入肌肉细胞 我们把它放回到这个像烤箱一样的装置 在你取下这片组织的6到8周后 你就能把器官植入到病人体中
这展示了智能材料 这个材料外部布满了细胞 我们对病人进行第一次临床试验 我们为每个病人制造特殊的智能材料。 我们让病人来医院， 在他们手术日期前的6到8周，进行X光检查 然后我们制造符合该病人尺寸的特殊材料 根据他们的盆腔尺寸。 试验的第二阶段 我们就只是预备了不同的型号，小号，中号，大号，特大 （笑） 真的。 我想大家都想要加大号，是吧？
（笑）
所以，膀胱肯定比其它结构 更复杂。 但现在有一些中空器官复杂性更多。 这是我们制造出的一个心脏瓣膜 我们用同样的战略制造这个心瓣膜。 我们有智能材料，我们植入细胞， 你看，这些瓣膜小叶正一开一合。 在植入人体前，这些材料会得到锻炼， 同样的战略
最复杂的是实质器官 实质器官更复杂 因为他们每厘米使用的器官更多 这是一个简单的实质器官，像耳朵 现在植入了软骨 那是那个像烤箱一样的装置 植入细胞后，我们就把整个材料放入其中， 数周后，我们就能取出这个特殊材料。
这记录了我们的制造过程， 我们植入很多层，一次一层， 首先是骨头，我们在缝隙中填入软骨。 在上面，我们植入肌肉。 然后你可以开始一层层的建成一个实体结构， 得到更复杂的器官。 但到目前为止，最复杂的实体器官是 是包含很多血管的实体器官。 器官连接很多血管的， 比如心脏， 肝脏，肾脏。 这是一个例子——我们有很多战略 来制造实体器官
这是其中之一。我们使用一个打印机 不使用墨水，我们使用——你刚看到，而我们的墨盒 是细胞 这就是你典型的电脑打印机 它实际上打印出了两个心室 一次一层 你看现在印出了一颗心，这大概需要40分钟时间 大约6小时之后， 你看那些肌肉细胞在收缩。 （鼓掌） 这项科技的发明者是Tao Ju,他在我们研究所工作。 当然，这现在还处在试验阶段， 还未运用到病人身上。
我们发明的另外一项战术， 是使用去细胞的器官。 我们接受捐赠者器官， 不再使用的器官 然后我们用非常柔和的洗涤剂， 把那些器官的细胞都洗掉。 比如，在左边的图上， 上面的图，你会看见一个肝脏。 我们接受捐赠的肝脏， 然后，使用温和清洁剂， 我们用这些温和清洁剂，可洗掉所有 肝脏的细胞。
两周后，我们可拿起这个器官， 它感觉像肝脏， 拿起来，感觉也像肝脏， 看起来，也像肝脏，但是它没有细胞， 剩下的 是肝脏的架子， 由胶原蛋白组成。 这是我们体内的一种物质，不会有排异， 我们就可以把它使用到不同病人身上。 然后我们拿来这个血管化的结构， 我们能证明我们保持了血管供应。
你看，这实际上是荧光显影术。 实际上，我们注射显影剂到器官里 你看，这是开始。我们正注射显影剂到器官， 到这个去细胞化的肝脏。 你可以看到这整个管道结构没受影响。 然后我们用细胞，管道细胞 血管细胞，我们用病人自己的细胞 注满这个树状的血管。 我们在肝脏外注满 病人自己的肝脏细胞。 然后我们就创造了一个有功能的肝脏。 这就是你现在看到的。 这还只是实验。但我们已经能够恢复这个肝脏的功能， 尽管是实验阶段。
而肾脏， 记得我一开始给你看的那幅画， 和我展示的第一张幻灯片。 90％在等待器官移植的病人， 90％都在等待肾脏移植。 所以，我们还有另外一个战术 那就是创造薄片 我们把他们堆积在一起，像手风琴一样 所以，我们把那些薄片堆积在一起，使用肾脏细胞 然后，你能看到我们制造出的迷你版的肾脏， 他们真的可以产生尿液。 但这还是小的结构，我们的挑战还是怎么样把他们变大。 这就是我们现在在研究所 研究的事情。 我想给你们总结的一件事情是 我们尝试向再生医学迈进所用的战略。
如果都可能的话 我们希望使用智能生物材料。 我们只需从架子上取下来一个智能材料， 就能重造你的器官。 我们现在重造的距离有限 但我们的目标是在未来扩大这个距离。 如果我们不能使用智能材料， 那我们倾向使用您自己的细胞。
为什么？因为它们不会有排斥反应。 我们可以从你身上取下细胞， 创造结构，放回到你的身体，他们不会有排斥反应。 如果可能，我们倾向于使用你同一个器官的细胞。 如果你气管有病， 我们希望从你的气管取下细胞。 如果你的胰腺有病， 我们希望从它上面取细胞。
为什么？因为我们宁愿取那些细胞， 是已经知道是你的身体需要的那种细胞的。 一个气管的细胞知道什么是气管细胞， 我们不用教它变成另一种细胞。 所以，我们倾向于你的某个器官的细胞。 今天，我们可以从差不多所有器官上取下细胞， 除了几个例外，（这几个）我们还需要它们的干细胞。 比如心脏，肝脏，神经及胰腺。 对于那些我们还需要干细胞的， 如果我们不能使用你身体的干细胞， 那我们就要使用捐赠者的干细胞。 我们倾向于不会有排斥反应的细胞， 并且不会形成肿瘤的细胞。
我们正大力研究干细胞。 这些结果两年前发表了。 他们是来自于羊水 和胎盘的干细胞。 现在，我想告诉你们 我们现在面临的主要挑战。 你知道，我刚给你们做的演讲，看起来非常好， 每个环节都很好。事实并非如此。 那些科技并不是那么简单。 你今天看到的一部分， 是我们研究所超过700个研究人员， 历时20年的研究成果。
所以，这些是非常难的科技。 一旦你摸索出了对的方法，你就能进行器官复制。 但这需要很多工作（才能摸索出对的方法）。 所以，我总是给大家看这个卡通 这展示了怎么样阻止一个失控的车。 你看到这个巴士的司机 上面的图里 他做了A,B,C,D,E,F， 他终于停下了失控的车 这是最基本的科学研究方法。 下面的是外科医生 （笑） 我是个医生，所以不是那么好笑。
（笑）
事实上方法A是正确的方法。 我的意思是我们任何时候把这样的科技 用于临床， 我们要绝对确保把这些科技运用到病人之前， 我们在实验室里尽了全力 保证这种科技的安全性。 当我们运用到病人身上时 我们要确保问了自己一个非常严肃的问题： 你是否觉得这个可以移植到你爱的人，你自己的小孩， 你的家人身上，然后我们再继续。 因为我们的首要目标， 是不造成任何伤害。
我现在给你们看一个短片， 一个病人的5秒钟短片。 她接受了我们制造的器官。 在14年前，我们就开始 移植这些器官。 所以，我们现在有生活着的接受了我们器官的病人。 有的时间已经超过10年。 我给你们看一个年轻女性的短片 她有先天的脊椎裂，一种脊椎异常。 她本来也没有正常的膀胱。这是CNN的一段录像。 我们只看5秒。 这部分是Sanjay Gupta录的。
录像：Kaitlyn M:我很高兴。我总是害怕 我会出事什么的。 现在我能走， 能跟我的朋友出去， 做我想做的事情。
Anthony Atala: 说到底，器官再生的诺言 是一个诺言 而且非常简单： 就是让我们的病人更好 谢谢你们的倾听。
（鼓掌）

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Anthony Atala on growing new organs
This is actually a painting that hangs at the Countway Library at Harvard Medical School. And it shows the first time an organ was ever transplanted. In the front, you see, actually, Joe Murray getting the patient ready for the transplant while in the back room you see Hartwell Harrison, the Chief of Urology at Harvard, actually harvesting the kidney. The kidney was indeed the first organ ever to transplanted to the human.

That was back in 1954. 55 years ago they were still dealing with a lot of the same challenges as many decades ago. Certainly many advances, many lives saved. But we have a major shortage of organs. In the last decade the number of patients waiting for a transplant has doubled. While, at the same time, the actual number of transplants has remained almost entirely flat. That really has to do with our aging population. We're just getting older. Medicine is doing a better job of keeping us alive. But as we age, our organs tend to fail more.

So, that's a challenge, not just for organs but also for tissues. Trying to replace pancreas, trying to replace nerves that can help us with Parkinson's. These are major issues. This is actually a very stunning statistic. Every 30 seconds a patient dies from diseases that could be treated with tissue regeneration or replacement. So, what can we do about it? We've talked about stem cells tonight. That's a way to do it. But still ways to go to get stem cells into patients, in terms of actual therapies for organs.

Wouldn't it be great if our bodies could regenerate? Wouldn't it be great if we could actually harness the power of our bodies, to actually heal ourselves? It's not really that foreign of a concept, actually; it happens on the Earth every day. This is actually a picture of a salamander. Salamanders have this amazing capacity to regenerate. You see here a little video. This is actually a limb injury in this salamander. And this is actually real photography, timed photography, showing how that limb regenerates in a period of days. You see the scar form. And that scar actually grows out a new limb.

So, salamanders can do it. Why can't we? Why can't humans regenerate? Actually, we can regenerate. Your body has many organs and every single organ in your body has a cell population that's ready to take over at the time of injury. It happens every day. As you age, as you get older. Your bones regenerate every 10 years. Your skin regenerates every two weeks. So, your body is constantly regenerating. The challenge occurs when there is an injury. At the time of injury or disease, the body's first reaction is to seal itself off from the rest of the body. It basically wants to fight off infection, and seal itself, whether it's organs inside your body, or your skin, the first reaction is for scar tissue to move in, to seal itself off from the outside.

So, how can we harness that power? One of the ways that we do that is actually by using smart biomaterials. How does this work? Well, on the left side here you see a urethra which was injured. This is the channel that connects the bladder to the outside of the body. And you see that it is injured. We basically found out that you can use these smart biomaterials, that you can actually use as a bridge. If you build that bridge, and you close off from the outside environment, then you can create that bridge, and cells that regenerate in your body, can then cross that bridge, and take that path.

That's exactly what you see here. It's actually a smart biomaterial that we used, to actually treat this patient. This was an injured urethra on the left side. We used that biomaterial in the middle. And then, six months later on the right-hand side you see this reengineered urethra. Turns out your body can regenerate, but only for small distances. The maximum efficient distance for regeneration is only about one centimeter. So, we can use these smart biomaterials but only for about one centimeter to bridge those gaps.

So, we do regenerate, but for limited distances. What do we do now, if you have injury for larger organs? What do we do when we have injuries for structures which are much larger than one centimeter? Then we can start to use cells. The strategy here, is if a patient comes in to us with a diseased or injured organ, you can take a very small piece of tissue from that organ, less than half the size of a postage stamp, you can then tease that tissue apart, and look at its basic components, the patient's own cells, you take those cells out, grow and expand those cells outside the body in large quantities, and then we then use scaffold materials.

To the naked eye they look like a piece of your blouse, or your shirt, but actually these materials are fairly complex and they are designed to degrade once inside the body. It disintegrates a few months later. It's acting only as a cell delivery vehicle. It's bringing the cells into the body. It's allowing the cells to regenerate new tissue, and once the tissue is regenerated the scaffold goes away.

And that's what we did for this piece of muscle. This is actually showing a piece of muscle and how we go through the structures to actually engineer the muscle. We take the cells, we expand them, we place the cells on the scaffold, and we then place the scaffold back into the patient. But actually, before placing the scaffold into the patient, we actually exercise it. We want to make sure that we condition this muscle, so that it knows what to do once we put it into the patient. That's what you're seeing here. You're seeing this muscle bio-reactor actually exercising the muscle back and forth.

Okay. These are flat structures that we see here, the muscle. What about other structures? This is actually an engineered blood vessel. Very similar to what we just did, but a little bit more complex. Here we take a scaffold, and we basically -- scaffold can be like a piece of paper here. And we can then tubularize this scaffold. And what we do is we, to make a blood vessel, same strategy. A blood vessel is made up of two different cell types. We take muscle cells, we paste, or coat the outside with these muscle cells, very much like baking a layer cake, if you will.

You place the muscle cells on the outside. You place the vascular blood vessel lining cells on the inside. You now have your fully seeded scaffold. You're going to place this in an oven-like device. It has the same conditions as a human body, 37 degrees centigrade, 95 percent oxygen. You then exercise it, as what you saw on that tape.

And on the right you actually see a carotid artery that was engineered. This is actually the artery that goes from your neck to your brain. And this is an x-ray showing you the patent, functional blood vessel. More complex structures such as blood vessels, urethras, which I showed you, they're definitely more complex because you're introducing two different cell types. But they are really acting mostly as conduits. You're allowing fluid or air to go through at steady states. They are not nearly as complex as hollow organs. Hollow organs have a much higher degree of complexity, because you're asking these organs to act on demand.

So, the bladder is one such organ. Same strategy, we take a very small piece of the bladder, less than half the size of a postage stamp. We then tease the tissue apart into its two individual cell components, muscle, and these bladder specialized cells. We grow the cells outside the body in large quantities. It takes about four weeks to grow these cells from the organ. We then take a scaffold that we shape like a bladder. We coat the inside with these bladder lining cells. We coat the outside with these muscle cells. We place it back into this oven-like device. From the time you take that piece of tissue, six to eight weeks later you can put the organ right back into the patient.

This actually shows the scaffold The material is actually being coated with the cells. When we did the first clinical trial for these patients we actually created the scaffold specifically for each patient. We brought patients in, six to eight weeks prior to their scheduled surgery, did x-rays, and we then composed a scaffold specifically for that patient's size pelvic cavity. For the second phase of the trials we just had different sizes, small, medium, large and extra-large. (Laughter) It's true. And I'm sure everyone here wanted an extra-large. Right? (Laughter)

So, bladders are definitely a little bit more complex than the other structures. But there are other hollow organs that have added complexity to it. This is actually a heart valve, which we engineered. And the way you engineer this heart valve is the same strategy. We take the scaffold, we seed it with cells, and you can now see here, the valve leaflets opening and closing. We exercise these prior to implantation. Same strategy.

And then the most complex are the solid organs. For solid organs, they're more complex because you're using a lot more cells per centimeter. This is actually a simple solid organ like the ear. It's now being seeded with cartilage. That's the oven-like device; Once it's coated it gets placed there. And then a few weeks later we can take out the cartilage scaffold.

This is actually digits that we're engineering. These are being layered, one layer at a time, first the bone, we fill in the gaps with cartilage. We then start adding the muscle on top. And you start layering these solid structures. Again, fairly more complex organs. but by far, the most complex solid organs are actually the vascularized, highly vascularized, a lot of blood vessel supply, organs such as the heart, the liver, the kidneys. This is actually an example -- several strategies to engineer solid organs.

This is actually one of the strategies. We use a printer. And instead of using ink, we use -- you just saw and inkjet cartridge -- we just use cells. This is actually your typical desktop printer. It's actually printing this two chamber heart, one layer at a time. You see the heart coming out there. It takes about 40 minutes to print, and about four to six hours later you see the muscle cells contract. (Applause) This technology was developed by Tao Ju, who worked at our institute. And this is actually still, of course, experimental, not for use in patients.

Another strategy that we have followed is actually to use decellularized organs. We actually take donor organs, organs that are discarded, and we then can use very mild detergents to take all the cell elements out of these organs. So, for example on the left panel, top panel, you see a liver. We actually take the donor liver, we use very mild detergents, and we, by using these mild detergents we take all the cells out of the liver.

Two weeks later, we basically can lift this organ up, it feels like a liver, we can hold it like a liver, it looks like a liver, but it has no cells. All we are left with is the skeleton, if you will, of the liver, all made up of collagen, a material that's in our bodies, that will not reject. We can use it from one patient to the next. We then take this vascular structure and we can prove that we retain the blood vessel supply.

You can see, actually that's a floroscopy. We're actually injecting contrast into the organ. Now you can see it start. We're injecting the contrast into the organ into this decellularized liver. And you can see the vascular tree that remains intact. We then take the cells, the vascular cells, blood vessel cells, we perfuse the vascular tree with the patient's own cells. We perfuse the outside of the liver with the patient's own liver cells. And we can then create functional livers. And that's actually what you're seeing. This is still experimental. But we are able to actually reproduce the functionality of the liver structure, experimentally.

For the kidney, as I talked to you about the first painting that you saw, the first slide I showed you, 90 percent of the patients on the transplant wait list are waiting for a kidney, 90 percent. So, another strategy we're following is actually to create wafers that we stack together, like an accordion, if you will. So, we stack these wafers together, using the kidney cells. And then you can see these miniature kidneys that we've engineered. They are actually making urine. Again, small structures, our challenge is how to make them larger, and that is something we're working on right now at the institute. One of the things that I wanted to summarize for you then is what is a strategy that we're going for in regenerative medicine.

If at all possible we really would like to use smart biomaterials that we can just take off the shelf and regenerate your organs. We are limited with distances right now, but our goal is actually to increase those distances over time. If we cannot use smart biomaterials, then we'd rather use your very own cells.

Why? Because they will not reject. We can take cells from you, create the structure, put it right back into you, they will not reject. And if possible, we'd rather use the cells from your very specific organ. If you present with a diseased wind pipe we'd like to take cells from your windpipe. If you present with a diseased pancreas we'd like to take cells from that organ.

Why? Because we'd rather take those cells which already know that those are the cell types you want. A windpipe cell already knows it's a windpipe cell. We don't need to teach it to become another cell type. So, we prefer organ-specific cells. And today we can obtain cells from most every organ in your body, except for several which we still need stem cells for, like heart, liver, nerve and pancreas. And for those we still need stem cells. If we can not use stem cells from your body then we'd like to use donor stem cells. And we prefer cells that will not reject and will not form tumors.

And we're working a lot with the stem cells that we published on two years ago, stem cells from the amniotic fluid, and the placenta, which have those properties. So, at this point, I do want to tell you that some of the major challenges we have. You know, I just showed you this presentation, everything looks so good, everything works. Actually no, these technologies really are not that easy. Some of the work you saw today was performed by over 700 researchers at our institute across a 20-year time span.

So, these are very tough technologies. Once you get the formula right you can replicate it. But it takes a lot to get there. So, I always like to show this cartoon. This is how to stop a runaway stage. And there you see the stagecoach driver, and he goes, on the top panel, He goes A, B, C, D, E, F. He finally stops the runaway stage. And those are usually the basic scientists, The bottom is usually the surgeons. (Laughter) I'm a surgeon so that's not that funny. (Laughter)

But actually method A is the correct approach. And what I mean by that is that anytime we've launched one of these technologies to the clinic, we've made absolutely sure that we do everything we can in the laboratory before we ever launch these technologies to patients. And when we launch these technologies to patients we want to make sure that we ask ourselves a very tough question. Are you ready to place this in your own loved one, your own child, your own family member, and then we proceed. Because our main goal, of course, is first, to do no harm.

I'm going to show you now, a very short clip, It's a five second clip of a patient who received one of the engineered organs. We started implanting some of these structures over 14 years ago. So, we have patients now walking around with organs, engineered organs, for over 10 years, as well. I'm going to show a clip of one young lady. She had a spina bifida defect, a spinal cord abnormality. She did not have a normal bladder. This is a segment from CNN. We are just taking five seconds. This is a segment that Sanjay Gupta actually took care of.

Video: Kaitlyn M: I'm happy. I was always afraid that I was going to have like, an accident or something. And now I can just go and go out with my friends, go do whatever I want.

Anthony Atala: See, at the end of the day, the promise of regenerative medicine is a single promise. And that is really very simple, to make our patients better. Thank you for your attention. (Applause)