Growing Personalized, On – Demand, Replacement Human Hearts
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 foreign  [Music]  hi there  well I have some good news and bad news  so the bad news the good news is I'm  here to tell you about curing the number  one disease affecting Humanity heart  disease  the bad news is  259 of you in this room  have heart disease  look to your left or your right and if  there's a person there  one of the two of you has heart disease 
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 if it's not you it's them  48 percent  of the population in the U.S has heart  disease  and one-third of all people in the world  die from heart disease  it's a number one killer worldwide of  men women and children  let me ask you a question how many of  you know a woman who's had breast cancer  raise your hand a lot of you  how many of you know a woman who's had  heart disease  not as many hands  and yet  five times more women have heart disease  and breast cancer  but we don't talk about that  why don't we talk about that I think in  part we don't talk about that because we 
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 blame people for their heart disease  we say oh if you ate right if you  exercise if you did all the right things  and didn't have didn't drink whatever  you wouldn't get heart disease and you  know what  lifestyle certainly plays a role but  that's not all of it  and heart disease doesn't have a face  like cancer does  but the reality is  to your right or your left  if it's not you it's them  heart disease is everywhere in the U.S  and rather than preventing it we talk a  lot about trying to intervene and treat  it  and we're not doing a great job because  every 34 seconds  34 seconds someone has a heart attack 
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 during this session this morning  105 people have had a heart attack in  the world  ten percent of those die within an hour  but the rest go on to have Progressive  problems that culminate in what we call  heart failure where your heart can't  pump enough blood to your body  and the only definitive cure for heart  failure is a heart transplant  And Then There are kids  one percent  of U.S births are kids with complex  congenital heart disease  do we blame them  oh gee you need a heart transplant  what you were born  we need to solve this problem 
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 because right now today if you need a  heart transplant someone has to die  before you're going to get one  and my goal is to change that  the truth is because someone has to die  for you to get a heart transplant we  only do on average 10 heart transplants  a day in the U.S  and there are 2 700 people waiting for a  heart any given day  .04 percent and what that means is those  2 700 people have made it onto the  waiting list for a heart  but typically you have to be very sick  to get on that list if you're not sick  enough you don't make the list if you're  too sick you don't make the list if  you're too young you don't make the list  if you're too old you don't make the  list  and if you cannot afford  to pay for the treatment you don't make 
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 the list  what that means is that the list of 2  700 people is much smaller than the  number of people who actually need  hearts  and that's been the status quo for 55  years  and if you're lucky enough to be one of  the people who gets a heart what that  means is that every day for the rest of  your life  you take drugs to keep from rejecting  that heart every day  you take drugs and those drugs can cost  up to thirty thousand dollars a month  and  they make you sick  they give you high blood pressure they  give you diabetes they can cause renal  failure there are people who've had  Hearts who have to get a kidney  transplant because the drugs they took  to keep them from losing their heart  made them lose their kidneys 
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 we have to change the status quo  and I'm committed to doing that  so my goal is to build personalized  on-demand replacement human hearts  build a personalized human heart not a  pig heart you heard recently about  someone receiving a pig heart as a  transplant and that was a big  breakthrough for a lot of reasons but  that person received a pig card not a  human heart and that person died several  months later for two reasons one they  had to be massively immunosuppressed  because even though they had received it  a quote Gene edited heart it was still  Pig  and  that pig heart had a virus  from the pigness of it all  and that individual couldn't fight the 
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 virus because they had been so massively  immunosuppressed  my goal is to personalize human hearts  which will reduce your risk  it'll reduce the lifetime cost of  transplants today a heart transplant  costs on the order of 2.3 million  dollars over the lifetime of an  individual we believe we can reduce that  by about 49 percent  it improves your quality of life because  if I give you a heart that matches you  then then it's like day one all over  again you got a heart you're not taking  drugs every day  and for the first time we have the  potential to cure  the number one killer on the planet  and beyond that if we can manufacture  them  we can make them available before you're  so sick  today 18 of people who receive a heart  transplant die in the first year because 
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 they were either so sick  when they got their heart that they  succumbed to all the other consequences  or  the immunorejaction immunosuppression  was a problem  by five years by ten years out 59  percent die  we can change that and I'm here to tell  you that building Hearts is no longer a  pipe dream  people say it's a moonshot I'm like no  it's I think of it more like getting  Percy to Mars you know  it it really was audacious times 10 but  guess what Percy's on Mars  and if we had one tenth of one percent  of the resources that it took to build  the rocket only to get Percy to Mars  we'd already be doing this in people  today  but this is a journey that started a  while ago and in 2005 when I had been 
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 doing cell therapy and heart for a while  I was like let's build a heart how hard  can it be  and then I was like what do we need to  build a heart well we need heart cells  and I don't know if you can see it but  these cells are beating in a dish  and the first time you see heart cells  actually beating in a dish it changed my  life I was like wow that's alive and  I'm dealing with something alive here  but you don't heart cells in a dish are  on the heart you need a place to put  those a framework if you will and  because my Mantra is give nature the  tools and get out of the way I said what  if we take a heart  and use the framework of that  to build the heart so what we did is we  took a heart and we developed a baby  shampoo basically that would let us wash 
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 all the cells out of that heart  so we could wash all the cells out and  what was left is what we called our  ghost heart the media dubbed it a ghost  heart it's a translucent  scaffold like a 2x4 of a house  into which I said okay now let's put  heart cells and see if we can build a  heart and within a year we had created a  beating heart in a lab  it was pretty cool so we had taken  something that was dead  added cells back and made it alive  but  and I want to I want to make this point  it might have been too much because  our scientific colleagues pushed back  hard  and it took us over two years to get the  paper published now since it was  published it's been deemed one of the  breakthroughs in science but it took us 
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 two years to get it published  and we had someone say oh that's not  novel and we had someone else who was  reviewing it say that's impossible  how do you reconcile those to make an  editor happy and there's there's  scientific media here we should talk  once it hit the world loved it it really  made a lot made a lot of sense to a lot  of people so I was like okay that it  took us until 2008 to get it published I  was like that wasn't too bad got  published on my mom's birthday in 2008  so it was a good day  but let's be honest we basically built a  rat heart it was a tiny tiny tiny heart  and David Letterman's joke about  politicians aside we weren't going to do  anything with the rap heart  so I said okay let's build a human heart 
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 how hard can it be  well let me tell you about the human  heart  the first thing I want to tell you is  your heart's about the size of your fist  and your heart weighs anywhere from 25  grams in a in a small child to about  350 grams in an adult or if you're a big  adult maybe 400 or have heart failure  maybe 450 grams why is that important  because to build a heart we need one  billion cells for every gram of tissue  one billion  so we had to figure out how to grow 350  billion cells and oh by the way heart  cells don't divide  so we couldn't just take some heart  cells and grow some more we had to back  up and say how can we do this and we had 
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 to get it right because if we're going  to build a human heart it has to be 60  to 80 beats per minute  every minute you don't want me to build  your heart that beats most minutes and  takes a minute off every once in a while  you know  and people have said well can't you do  it cheaper I'm like yeah I can but do  you really want that hard  I'll give it to you if that's what you  want but I don't think you do  so  the other thing is the heart is an  amazing organ  over our lifetime it creates enough  energy to power a Mac Truck to the Moon  and back  we have to build something that could do  that  and it pumps 1.5 million barrels of  blood over the course of your lifetime  and to do that it has to have a blood  supply that is amazing and in fact the 
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 heart has and this is one of our ghost  Hearts getting hooked up to getting  transplanted it has to have 60  000 miles of blood vessels  and we had to rebuild those so no  challenge how hard could it be  well fast forward 12 years where we had  to create a way to take stem cells from  a person  from your bone marrow or your blood or  your skin and grow those billions of  cells and that took me 12 years of my  life  but then we also had to figure out every  single piece of how to build this heart  how do we put the two together where do  we do it how do we feed it what do we  feed it you don't normally find Hearts  growing in the wild you know  um so we had to figure it out  fast forward 12 years 
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 and we were able to go  from a three gram heart to an eight gram  heart  now all over again I just want to point  out we had this rejected in multiple  medical journals because again it pushed  the status quo well that's not really a  hard  okay it pumps blood it looks like a  heart it acts like a heart what do you  want oh well you didn't use this  antibody so we don't believe it it was  crazy  and I I do want to talk about at some  point so ask me during the break the  pushback that people get when they try  to innovate  but  I said okay it took us 14 years to go  from two grams three grams to eight  grams we basically doubled the size of  the heart  so if that or tripled the size of the  heart if that's the rate at which we can  do this it's going to take 42 years to 
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 build the heart large enough to help a  young girl a teenage girl and every day  there are hundreds of people dying  waiting for a heart  not acceptable  we have to change this  so I got smarter we got smarter and I  started the company and I said screw  publishing necessarily for the sake of  science  let's get this to patience now that  doesn't mean I don't do science I do  science or love ideas I continue to do  ideas I've already spoken with multiple  of those earlier speakers backstage  about new ideas and it makes me very  happy  but my goal is to cure heart disease in  my lifetime  so I said let's start a company  organomat Oregon Amat organ environment  and Latin for those of you who care  that's going to build on-demand  personalized hearts and then I went in 
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 search of Partners and I found a  Department of Defense partner Army  biofab USA a Department of Defense  funded initiative that introduced me to  strategic Partners who were members of  army and by doing that  I was able to take the things we had  done by hand teach them how to do them  and we automated them oh yeah the part I  forgot to say is we got to the point  that we could do it over and over and  over we did it hundreds of times  building these  and every time we failed  we failed because it got contaminated  because we're doing this without  antibiotics  in a laboratory setting by hand  and we had to build all the tools to do  it and somebody had a bad day and 
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 sneezed  it was over  so we would do this and we would pray  for two days every time we did one of  these that two days later was still  going to be sterile  so we had to figure out how to get  people out of it so we found strategic  Partners who would help us automate this  so we were able to go from doing it by  hand to showing them how to use a  machine and automating growing cells and  then creating that ghost heart you can  see literally our Rube Goldberg homemade  apparatus in the middle there  that we used until we found Partners who  could help us automate it and then we  made one that looks much more Spacey I  love it it's more like what you would  see on Proteus than than you know and  then rather than injecting by hand my  new best friend is Bab the robot the bio 
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 assembly bot that I taught how to inject  cells  and by doing that we were able to create  this automated assembly line  that let us go in less than one year  to a 50 gram human heart that's beating  in the lab  and we've begun to transplant those now  in animals with the goal of doing this  in people  that's a human heart built  by by us and a robot  and the first time you see that it kind  of makes you cry  it's very humbling  and I had intended to have hearts here  today to show you and I have to thank  Ronnie and Randy and dab and everyone  who tried to make that possible and the  storms across the Northeast shut down  the airport and the hearts were stuck on  the tarmac 
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 imagine how that feels if you're someone  waiting for one for transplant so how do  we do this going forward I'm almost out  of time the way we do it is it  48 percent of you have heart disease  you know  a third of people in the world die from  heart disease  you know  someone in your family has heart disease  your mom died from it your dad died from  it  let us Bank yourselves now and grow  those billions of cells today because a  rate limiting step in this is the 12 to  14 weeks that it takes to grow those  cells  and then we store your cells we have our  on-the-shelf scaffold we grab it off the  shelf  and six months in advance when you and  your surgeon or cardiologist say Jim's  going to need a heart we start building  you a heart 
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 so where are we with this well you know  I just want to make a point for the  younger folks in the lab we've had to  persist and given the right  opportunities  we're going to be doing this in people  in five years  we have a plan given the right resources  to be in first and human in five years  [Applause]  but the other thing I want to say is  even though it's been hard  we spend more time at work than we do at  home so you have to have fun  and Stephen Hawking heard about what we  were doing and that we were building  hearts for with stem cells and he asked  us to do a flash mob for him  now as a scientist I shouldn't admit  this I didn't know what a flash mob was  but but we did I learned and  if you have fun then you can do amazing 
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 things and rather than thinking about  intervening or treating I believe we can  cure heart disease and we can build a  personalized Innovative cure and this  picture here on the bottom right  is a little girl Katarina who is going  to need one of our hearts  and her mom has created a foundation  called  buildingthecure.org to support what we  do I encourage you to look at our  website but go look at that Foundation  and help Katarina and other kids with  complex congenital heart disease finally  I just get to stand up here and talk but  it's really about bab and the team that  make this real  I'm just the person with the big mouth  they're the ones they're doing it every  day so thank you very much and come talk  to me 
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 [Music]  thank you 



