McGowan Institute?
March 2005 | VOL. 3 | www.McGowan.pitt.edu
Under the leadership of Sanjeev G. Shroff, PhD the National Institutes of Health (NHLIB) has awarded the Department of Bioengineering a pre-doctoral training program aimed at educating talented students from engineering and other quantitative sciences for careers in biomedical research in the cardiovascular area. The University has been at the forefront of education and research in this field, with two key components contributing to this status:
- First, a mechanism is in place whereby our students are exposed first-hand to actual clinical problems requiring bioengineering input for their solution within various medical disciplines (e.g., cardiology, cardio-thoracic surgery, vascular surgery, radiology).
- Second, there has been, and continues to be, a significant Institutional commitment to these research and educational endeavors.
The new program is interdisciplinary and interdepartmental in nature. Although the Department of Bioengineering forms the core, the training faculty is drawn from a number of departments: Chemical Engineering, Cell Biology & Physiology, Medicine (Cardiology), Critical Care Medicine, Pediatrics (Cardiology), Surgery (Cardio-thoracic and Vascular), and Radiology.
The participating faculty members are (bio)engineers, physiologists, biophysicist, cell and molecular biologists, adult and pediatric cardiologists, cardio-thoracic surgeons, and critical care specialists, with vigorous and well-funded research programs.
There are three focus areas of this program:
- Basic understanding and quantitative characterization of native (normal and pathological conditions) and perturbed (i.e., with deployment of man-made devices or constructs) cardiovascular function at various levels of organization (cell, tissue, whole organ),
- Imaging for functional assessment at various levels of organization (cell, tissue, whole organ), and
- Design and optimization of artificial devices and constructs (mechanical, tissue-engineered, and hybrid).
Students will be drawn mainly from engineering schools, although they may also come from biology, physics, chemistry, and mathematics. Program coursework (12 didactic courses and several workshops) is designed to provide both breadth and depth in engineering and biological sciences and also includes a formal exposure to biostatistics, bioethics, and professional and career development issues. One novel aspect of the program is that students are required to formally participate in a clinical experience (Clinical Internship and Rotation). Finally, each student receives extensive research training in the laboratories of the training faculty.
We believe the new program provides a unique educational and research experience with respect to basic and applied cardiovascular engineering and sciences.
This new program compliments the current training programs in this region and expands the opportunities in the Undergraduate, Pre and Post Doctoral Tissue Engineering Training Programs
The McGowan Institute for Regenerative Medicine has in place an NIH finded educational program “Cellular Approaches to Tissue Engineering and Regeneration” (CATER)
The goal of the CATER training program is to provide a solid foundation upon which to build a productive independent career in cellular and tissue based therapy for human disease and injury. This goal is accomplished via a highly coordinated and mentored interdisciplinary training program with a combination of required and elective courses, research activities, and specialized training opportunities and grants.
This is the only region in the country that provides training in tissue engineering for Undergraduates (PTEI), Pre-Doctoral (McGowan Institute and Bioengineering) and Post-Doctoral (PTEI) students that is supported through NIH training grants.
Health Care Hero Awards Presented to Dr. Kormos and Dr. Herberman
The Health Care Hero Awards program annually recognizes outstanding people and organizations that are making significant strides in the local health care field. The McGowan Faculty who were recognized for 2005 are Drs. Robert L. Kormos, Ronald Herberman who received the awards for Physician category and Lifetime achievement respectively and Dr. Stephen Badylak who was a finalist in the Health Care Innovation & Research category.
Robert L. Kormos, M.D. was selected as the 2005 Health Care Hero Award-Physician Category. This award is to recognize “effective clinical outcomes compared to past practice, and increased patient satisfaction”. In the case of Dr. Kormos, through his pioneering clinical procedures he is recognized on a world-wide basis for success in coronary care and cardiac transplantation.
Dr. Kormos is the Director of Cardiac Transplantation, and the Director of the Artificial Heart Program at the University of Pittsburgh Medical Center, and the Medical Director-McGowan Institute for Regenerative Medicine.
By way of background, under Dr. Kormos’ leadership, over 300 patients have received heart transplants at the Medical Center. One of the strategies that Dr. Kormos has successfully used to stabilize a patient in need of a heart transplant is to implant a ventricular assist device-a special battery powered blood pump that assists the heart while waiting for a heart suitable to the patient. On average, Dr.
Kormos implants about 30 to 35 ventricular assist devices (VAD) per year as a “bridge to transplantation”.
Three recent significant achievements of Dr. Kormos include: 1) development of the VAD technology as a “bridge to recovery”; 2) the use of VAD technology as “destination therapy”, and; 3) the use of patient’s own stem cells as a means to repair sick hearts and possibly avoid the need for a heart transplant.
Development of the VAD technology as a “bridge to recovery”
The Clinical Artificial Heart Program at the University of Pittsburgh Medical Center (UPMC) ended Fiscal Year 2004 in remarkable fashion. In the previous 12 months, the team, under the direction of Dr. Robert L. Kormos, Director of Cardiac Transplantation, experienced unprecedented growth.
Between July 1, 2003 and June 30, 2004, 34 patients were implanted with cardiac assist devices (VADs) at UPMC Presbyterian and Children’s Hospital of Pittsburgh, eclipsing the previous record of 28 during FY03. The composite at the right shows different VADs that are selected based on the specific patient’s condition. While the use of VAD’s as a bridge to transplantation is remarkable, even more exciting is the work of Dr. Kormos to use the VAD as a “bridge to recovery”. In selected cases, Dr. Kormos has been able to implant a VAD, give the patient’s heart a rest, and as a result of this “reduced load condition” the patient’s heart has been able to regenerate; with this “recovery” the VAD was removed, and the patient was removed from the transplant list. In the past two years, Dr. Kormos has used the VAD as a means to “cure” for 12 patients-without requiring a heart transplant.
Use of VAD technology as “destination therapy”
In July 2004, Dr. Kormos implanted a left ventricular assist system in a patient whose condition dictated that heart transplantation was not an option for long-term survival. Using this new therapy allows Dr. Kormos to return people to productive lives at home as an alternative to dying from end-stage congestive heart failure. This “Pittsburgh first” was in fact only the second such procedure performed in the United States. See the attached description which elaborates on this accomplishment.
Use of stem cells as a means to repair sick hearts
In conjunction with his colleague Dr. Amit Patel, Director of Cardiac Stem Cell Therapy, Dr. Kormos has shown that injections of adult stem cells into damaged heart tissue significantly improved heart function in patients with severe congestive heart failure. This report (April 2004) was based on the studies that Dr. Patel and his colleagues had conducted in other countries. It was the first prospective randomized trial of this experimental cellular therapy.
To further this research and make it available in Pittsburgh (and the USA), Drs. Kormos and Patel are in the final stages of FDA approval to conduct follow on studies here. Upon FDA approval, in 2005 the pilot study will move forward in Pittsburgh. This study will document what potential changes occur in the myocardium following transplantation of these cells. Furthermore, detailed characterization of the injected cell population will be performed, in an effort to understand the biology of the transdifferentiation process. This study provides a unique opportunity to observe the effects of the progenitor cells in-vivo in the patients with congestive heart failure (CHF).
Dr. Kormos’ pioneering clinical work has had a profound impact on many desperately sick patients, and his innovation and surgical skills has resulted in life-saving outcomes to many patients. Congratulations on your selection as the 2005 Health Care Hero Award-Physician category.
Ronald Herberman, M.D. is recipient of the 2005 Health Care Hero Lifetime Achievement Award. The award is presented to an individual who has dedicated one’s professional or volunteer life to substantially improve health and health care for the people of the region.
Dr. Herberman is the Director of the University of Pittsburgh Cancer Institute, as well as the Associate Vice Chancellor for Cancer Research within the School of Medicine, Department of Health Sciences. In this capacity, he has the responsibility for enhancing and facilitating the basic and clinical research activities of the six schools of the health sciences and of the University of Pittsburgh Medical Center (UPMC). In addition, he is a Hillman Professor of Oncology as well as a Professor of Medicine and Pathology at the University and remains personally involved in several cancer research programs.
Prior to coming to the university, in 1968 Dr. Herberman became a senior investigator in the immunology branch of the National Cancer Institute, where he organized a research program related to tumor and cellular immunology. In 1971, he became head of a newly established cellular and tumor immunology section in the Laboratory of Cell Biology of the National Cancer Institute. During this period, he had responsibility for a research program of several investigators related to studies, in animal model systems and in patients with cancer, of cell mediated immune responses to tumors. During this period, a new category of lymphocytes was discovered in Dr. Herberman's laboratory and termed natural killer (NK) cells. Since then, much of Dr. Herberman's research has been focused on the characterization of these natural effector cells and on their role in resistance to cancer growth.
In 1975, the National Cancer Institute organized an intramural and extramural research program focused on immunodiagnosis of cancer. Dr. Herberman was selected as the Chief of the new Laboratory of Immunodiagnosis, National Cancer Institute, and also assumed responsibility for the national contract program on immunodiagnosis of cancer.
In 1981, Dr. Herberman was asked to assume responsibility for another new branch of the National Cancer Institute, the Biological Therapeutics Branch of the Biological Response Modifiers Program. He had responsibility for a large laboratory and clinical program devoted to the development of biological response modifiers for the treatment of cancer. In 1983, he also assumed responsibility for the overall Biological Response Modifiers Program, serving for the next two years as the Acting Director. In this capacity, he supervised the national extramural programs of the National Cancer Institute related to biological response modifiers as well as continued his responsibility for the intramural laboratory and clinical research program in this area.
Dr. Herberman’s pioneering research and aggressive clinical translation has had a profound impact on many patients around the world, and his innovation and leadership has resulted in life-saving outcomes to many patients. Congratulations on your selection as the 2005 Health Care Hero Lifetime Achievement Award.
Dr. Stephen Badylak was a finalist in the 2005 Health Care Hero Award-Innovation & Research category. This award is to “breakthroughs in medical technology”, and seeks to assess the scope of coverage (impact) of the new technology. One clear measure of achievement and impact is the number of individuals whose quality of life, and/or time to recovery has been improved by the scientific achievement. In the case of Dr. Badylak, through his pioneering discoveries and his aggressive pursuit of the transition of his technologies from his lab to clinical practice, over 300,000 patients have benefited from his tissue engineering technologies. On a world-wide basis, this is clearly the most successful and widely utilized tissue engineering technique that has ever reached clinical practice. Congratulations on your recognition.
Over 200 faculty, trainees and guests attended the Fourth Annual McGowan Institute Scientific Retreat at Nemacolin Woodlands. The Retreat, held on March 7 and 8, featured invited lectures by Drs. Toshiharu Shinoka, Tokyo Women’s Medical University, Elliot Chaikof, Emory School of Medicine, and Colonel Craig Shriver, Walter Reed Medical Center.
In the photograph above, Elliot Chaikof, M.D, Ph.D. of the Emory School of Medicine addresses the retreat participants. Dr. Chaikof provided a review of past achievements in tissue engineering and shared his vision on the future. He challenged the researchers to learn from the past accomplishments and to ensure that future successes are focused on our customers…the patients. “We need to use our achievements as the foundation for our current projects” said Dr. Chaikof.
This year’s retreat included a session on achievements in clinical translation and how to identify opportunities to expedite the movement of new innovations from the laboratory to the clinic. Another highlight of the meeting was the poster session where 58 papers were presented. A panel of judges evaluated all of the papers and selected the best submissions in the categories of Artificial Organs and Medical Devices, Biomaterials and Tissue Engineering, and Cellular Therapies. The lead authors on the best papers were Joie Marhefka, Peggy Muller, Reecha Wadhwa, with honorable mention going to the papers whose lead author was Heide Eash, Clayton Yates, and Sang Beom Lee.
The retreat activities included focused breakout sessions where attendees discussed the next generation of medical devices and artificial organs, the status of cellular therapy research and clinical trials, opportunities for regenerative medicine to assist in traumatic injuries, and opportunities to make quantum advances in regenerative medicine.
Hospitalizations due to heart failure and lung fluid buildup are common and could be prevented with early intervention.
Srinivas Murali, M.D., professor School of Medicine, director of the Heart Failure Network at the Cardiovascular Institute and McGowan Institute faculty member led a team that implanted the area’s first biventricular pacemaker/defibrillator that also monitors fluid build up in the heart and lungs, which is a primary indicator of worsening heart failure and often results in patient hospitalization
The device, called the Medtronic InSync Sentry™ cardiac resynchronization therapy (CRT) defibrillator system, was implanted on Friday, March 4. It was approved by the U.S. Food and Drug Administration in November 2004.
Congestive heart failure afflicts 6 million Americans and is the number one cause of hospital admissions, with most of these admissions due to fluid accumulation in the lungs. Fluid buildup often goes undetected until the patient becomes critically ill, requiring hospitalization or urgent treatment at an emergency room for severe shortness of breath. With approximately 1 million hospitalizations each year for heart failure at a cost of an estimated $40 billion annually, heart failure management is a tremendous cost burden to the country’s health care system.
The device provides vital patient information to physicians who implant CRT defibrillator systems and also to physicians who manage the ongoing care of heart failure patients. In the future, physicians will be able to access data gathered by the system using the Internet and through wireless transmissions that won’t require direct patient interaction.
CRT resynchronizes the contractions of the heart’s lower chambers by sending tiny electrical impulses to the heart muscle, which can help the heart pump blood throughout the body more efficiently and reduce heart failure symptoms. The system’s defibrillation capability treats potentially lethal heart arrhythmias, thus saving lives.
In 2002, the McGowan Institute established the McGowan Institute Graduate Student Network (MIGS-Net), a program for graduate students of the Bioengineering and Interdisciplinary Biomedical Sciences. The mission of the MIGS-Net was to facilitate networking among the students of these diverse disciplines by supporting biweekly seminars, newsletters and sponsoring travel awards to conferences and workshops. This network enabled improved collaborative activities amongst students that have an interest in regenerative medicine, but are in different academic departments.
Under the leadership of Drs. Satdarshan (Paul) Singh Monga and Kacey Marra, the scope of those included in the program has broadened to include the post-doctoral trainees. To reflect the expanded coverage of the program, this successful initiative has been renamed as the McGowan Trainee Career Advancement Program or the MTCAP.
“By including post-doctoral fellows in the program, the graduate students of the bioengineering and interdisciplinary areas will interact and network with the post-doctoral fellows. This interaction thus stimulates opportunities for both groups that typically did not occur so frequently in the past” said Dr. Monga. He further said, “Our first goal was to initiate graduate student contact between disciplines and since we successfully did that, we have moved on to provide a stable and long term opportunity for students and fellows to network collaborate and educate each other, under the umbrella of MTCAP. Now that we have formally put them under one roof, we anticipate more frequent and extensive crosstalk”.
Membership in MTCAP is available free of cost to all graduate students and postdoctoral fellows, who belong to the laboratories of the MIRM faculty. MTCAP offers a number of benefits that include travel scholarships, seminars, newsletters, and other activities. The travel scholarships allow students to attend workshops and present their work at meetings and conferences. A new addition to this program is a six monthly, single-topic discussion meeting. The first one in this series will be the “Stem Cell Mixer” and is tentatively scheduled for mid-June.
The seminars and workshops are held on campus to serve as a platform for networking with faculty and other students and is also part of the annual MIRM retreat. These seminars are a wealth of information and are conducted by experts in the fields of biotechnology. Examples include advances and applications in the field of tissue engineering, stem cell research and artificial organs. At the same time the students and postdoctoral fellows present their work in an interactive discussion group format. For more information on MTCAP, please contact Dr. Monga or Dr. Marra.