ViVita Technologies includes UC Davis vet, three biomedical engineering doctoral students.

The winning team for both first place and People's Choice: (from left) Maelene Wong, biomedical engineering graduate student; Leigh Griffiths, assistant professor of veterinary medicine and epidemiology; Jeni Lee, biomedical engineering graduate student; and Gina MacBarb, biomedical engineering graduate student.

A new approach to tissue preparation that makes heart valve replacements less likely to be rejected by the body’s immune system — potentially giving transplant patients longer, healthier lives — was the clear favorite in this year’s UC Davis business plan competition — sweeping both the first prize and the People’s Choice award.

ViVita Technologies, a team comprising a UC Davis veterinarian and three biomedical engineering doctoral students, took home a total of $12,000 in the 13th annual Big Bang! Business Plan Competition, run by MBA students in the UC Davis Graduate School of Management: $10,000 for first place, decided by a team of judges, and $2,000 for the People’s Choice award, decided by a vote of the approximately 150 people who attended the awards ceremony Thursday evening (May 16) at the UC Davis Conference Center.

Second prize of $5,000 went to Davis Chem, a team that is working to commercialize a sustainable method of producing isobutryaldehyde, a common base chemical used in everything from paint to cosmetics, with genetically modified E. coli bacteria rather than with the petroleum products currently used in production.

ViVita Technologies was driven to create its product to address the current shortage of organs. “But unlike with current heart valve transplants, the patient would be free from a lifetime of drugs,” said Maelene Wong, chief executive officer of the nascent company.

The ViVita process removes substances that trigger patients’ immune response while preserving the structural integrity and functional properties of the replacement valve tissue. The method has been successfully tested on small animals, they said.

The proprietary process allows the patient’s own cells to join and grow with the transplant tissue — a process that the team says could eventually be used for any organ transplant. Such an organ transplant would allow the person to lead a normal, healthy life without fear of organ rejection and the need to spend a lifetime on anti-rejection medication. It would also allow for better transplant methods for children, who often need new transplants, and additional surgeries, when their bodies grow, Wong said.

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Grandfather, 57, treated at UCLA, enjoying life with his family.

Fernando Padilla could barely breathe or walk more than a few steps. An incurable disease, pulmonary fibrosis, was causing his lungs to turn to hardened scar tissue, and he was permanently tethered to an oxygen tank. His only hope was a double lung transplant.

In November 2012, he got an early-morning call that a pair of donor lungs was available.

Upon arriving at Ronald Reagan UCLA Medical Center, he was told of a new study testing an experimental device — a portable organ-preservation system that keeps donor lungs functioning and “breathing” in a near-physiologic state outside the body during transport to a recipient, instead of the standard method, in which the organs are kept in an icebox in a non-functioning, non-breathing state.

Fernando Padilla and his wife

Padilla consented to participate in the study and was randomized to become the first patient at UCLA — and in the United States — to undergo the ‘breathing lung’ transplant using the TransMedics Organ Care System (OCS).

“If they’ve got new technology to deliver the lungs still breathing, I think that would be better than trying to wake them back up again after being on ice,” said the former construction worker, who had helped build the very same hospital where he was now a patient. “I’m just following technology.”

With the OCS, the lungs are removed from a donor’s body and are placed in a mobile high-tech box, where they are immediately revived to a warm, breathing state and perfused with oxygen and a special solution supplemented with packed red-blood cells. The device also features monitors that display how the lungs are functioning during transport.

“Lungs are very sensitive and can easily be damaged during the donation process,” said Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of the heart and lung transplantation program at UCLA. “The cold-storage method does not allow for reconditioning of the lungs, but this promising technology enables us to potentially improve the function of the donor lungs before they are placed in the recipient.”

In addition, the technology could help transplant teams better assess donor lungs, since the organs can be tested in the device, over a longer period of time. It could also help address the shortage of available organs by allowing donor lungs to be safely transported across longer distances, expanding the donor pool for the more than more than 1,650 Americans who are currently on the waiting list for a lung transplant.

Padilla’s donor lungs were transported, using the OCS, from a neighboring state to UCLA. His seven-hour transplant surgery was a success, and he now relishes every deep breath. The oxygen tanks are long gone. He walks several miles a day with his wife, plays with his grandkids and enjoys life with his family. They are immensely grateful to the organ donor who supplied him with the precious “gift of life.”

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“If a patient is very obese, he bears a lot of risks and complications.”

Suitulaga “Sugi” Hunkin has been overweight most of his life. He attributes that to his love of food and his Samoan ancestry.

Because of his size, he also had trouble breathing and experienced irregular heartbeat – symptoms his doctors diagnosed as heart disease called cardiomyopathy, which usually leads to heart failure.

“Here I am thinking I’m on top of the world at the age of 27 and all of a sudden I ran into a brick wall,” said Hunkin, who tipped the scale at 350 pounds by his mid-20s. “I couldn’t believe it. I was in denial.”

He needed heart transplantation surgery to replace his failing heart, but before that could happen, he needed to lose at least 100 pounds.

“If a patient is very obese, he bears a lot of risks and complications, inter-operatively as well as post-operatively,” said Georg Wieselthaler, M.D., professor of surgery of UC San Francisco’s Division of Adult Cardiothoracic Surgery, and director and surgical chief of the UCSF Cardiac Transplantation and Mechanical Circulatory Support. “And therefore it’s absolutely favorable for patients to try and have a body mass index of below 35 before going into a complex operation.”

Body mass index (BMI) measures a person’s body fat based on height and weight. Normal BMI is between 18.5 and 24.9; overweight is 25-29.9; and obesity is BMI of 30 or greater.

Hunkin chose UCSF to help him with his heart failure. Its pioneering cardiothoracic surgery program was established 50 years ago by chair Leon Goldman, M.D., and Benson Roe, M.D.. The Heart and Lung Transplant Program has historically had high one-year survival outcomes among academic surgery programs nationally.

To help Hunkin stay alive, Wieselthaler installed a ventricular assist device (VAD), a mechanical device that helps a failing heart pump blood. The VAD allowed Hunkin stay alive, but it did not help him lose weight.

“A switch clicked in my head,” he said. “I need to get on the ball. It’s not fair to my wife and my kids, and it’s not fair to myself. It’s not fair to the doctors that are treating me. Everybody’s doing so much. It comes down to me.”

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Alfonso Garcia is spreading the word about the value of organ donation.

Alfonso Garcia and his parents pose with the UCSF medical team that cared for him during his 2010 life-saving liver transplant.

Alfonso Garcia still carries around a baseball cap that belonged to a 22-year-old man who passed away in 2010 having never met him. But the cap is just a small token of an even bigger reminder that the 18-year-old college freshman carries with him every day: the man’s liver, which saved Garcia’s life.

Since receiving the liver transplant at UC San Francisco, Garcia has made it a mission to spread the word about the value of organ donation by sharing the memory of his hero, George Becker, who died after a bad sinus infection spread to his brain.

Years later, Garcia still “thinks about George every day,” he said. “I don’t take anything for granted.”

As part of that mission, Garcia was selected by UCSF and the California Transplant Donor Network to ride on the Donate Life “Journeys of the Heart” float at the 2013 Tournament of Roses Parade in Pasadena on Tuesday, Jan. 1., in honor of Becker. The float will bear a florograph of Becker – a portrait made of flowers.

Garcia – whose father, Oscar Garcia, is a respiratory therapist at UCSF – was 15 years old when he was diagnosed with Wilson’s disease, a genetic disorder in which too much copper accumulates in the body’s tissues, causing damage to the liver and nervous system. His health was deteriorating quickly and he needed a liver transplant immediately.

Becker, who signed up to be an organ donor on his driver’s license when he was 16, ended up being the right match. And Garcia’s UCSF medical team – which included transplant surgeon Ryutaro Hirose, M.D.; Philip Rosenthal, M.D., medical director of the Pediatric Liver Transplant Program; Emily Perito, M.D., a clinical fellow in pediatrics and gastroenterology; and nurse practitioner Susan Diaz, M.S.N. – performed a successful transplant.

“It’s something that I appreciate and hold very close to my heart, the people at UCSF,” said Garcia, now a healthy, strong young man who just started attending the University of San Francisco. “Growing up, seeing my dad go to work every day, I didn’t know the significance of that until the day I was under the care of UCSF. I was like, ‘Wow, these people do an incredible job day in and day out to care for people and save people’s lives.’”

Recognized as a world leader in organ transplantation since 1964, the UCSF Organ Transplant Service has performed transplants for more than 10,000 patients and has played a key role in defining the field. The UCSF Liver Transplant Program, designated as a “Center of Excellence” by the U.S. Department of Health and Human Services, performs more liver transplants than any other hospital in Northern California – more than 2,300 liver transplants for adults and children since it began in 1988.

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Related link:
Rose Parade tribute to a Bruin who saved lives

UCLA to be represented at Jan. 1 event.

Molly Noble

Molly Noble’s heart belonged to UCLA from the time she was in the fifth grade although she knew her divorced mother probably couldn’t afford the tuition. So Molly, whip-smart, worked twice as hard to ensure she would be awarded scholarships. And it paid off.

In 2001, she graduated as valedictorian of her Rio Linda High School class and entered UCLA as a National Merit Scholar and a UC Regents Scholar. “It was her dream ever since she was little to go to UCLA, and that dream came true,” said her mother Dorothy Noble-Fairbairn.

Although Molly came close to donning a mortarboard and walking with her classmates at Commencement, sadly, she didn’t make it. The story of what she gave back to UCLA and to the recipients of five of her donated organs will be one of the 72 such stories honored New Year’s Day on the 2013 Rose Parade Donate Life float that will carry her picture in flowers.

Riding on the same float will be Vicky Nguyen, 28, a recipient of two liver transplants performed at UCLA by Dr. Ronald Busuttil, chairman of the Department of Surgery and chief of liver and pancreas transplantation. Nguyen is one of 32 organ and tissue recipients picked to participate in the 2013 Rose Parade. In addition, two award-winning UCLA nurses will be riding atop the Nurse.com float.

Molly’s gift of life

Although Molly was just three courses shy of graduating from UCLA, she decided to take a break from her studies to travel out east and think about what she wanted to do with her life, her mother said. Molly later returned to L.A. with the goal of finishing her college education. And the first step was to apply for a student loan and enroll in one of the courses she needed at a community college in Victorville in June 2009.

But her overall goal, her mother said, was to finish her last two courses at UCLA in the fall. Then fate intervened. While grocery shopping, Noble fell. Not a serious accident, her mother first thought until she received a call from a neurologist at Arrowhead Regional Medical Center. A scan revealed a severe brain bleed, and Molly, at age 26, was in a coma from which she would not wake.

Although Molly had taken the bus everywhere in L.A., she applied for a driver’s license two months before she collapsed. And, in another fateful move, she had checked the box for organ donation. So she was kept on a respirator for several days to allow her organs to be harvested. Her heart and a lung, transplanted at the Ronald Reagan UCLA Medical Center, saved the lives of two gravely ill patients. Her kidneys and liver went to recipients elsewhere.

“They told me they had taken her heart and lung and flew them in a helicopter through the (July 4th)  fireworks to UCLA for transplant,” Noble-Fairbairn said. “We thought that was bittersweet and beautiful that her heart was going home to UCLA, the place she loved so much.”

The university awarded Molly her degree in psychology posthumously, and it hangs together with a picture of the Powell Library — her daughter’s favorite building on campus — in Noble-Fairbairn’s home in Missouri.

On Jan. 1, Noble-Fairbairn will be front and center when the Donate Life float rolls by to see up close and personal the “floragraph” of her daughter. UCLA Health System, who sponsored Molly as an honoree on the float, is flying Noble-Fairbairn and her husband out to Pasadena so they can watch the parade from the grandstands.

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Related links:

• Two UCLA nurses are Rose Parade-bound
• UCSF transplant patient and donor to be in Rose Parade

Media advisory: Dec. 10 pre-parade event.

Alfonso Garcia with Connie May, the mother of his donor

WHAT: Former UC San Francisco transplant patient Alfonso Garcia, 18, has been selected as a rider on the Donate Life “Journeys of the Heart” float at the Tournament of Roses Parade in Pasadena on Jan. 1, 2013.  He will do so to honor his donor, George Becker, who died at age 22 in 2010. A likeness of Becker will be captured in a floragraph, which is a portrait made of flowers, on the same float in this annual, internationally televised event.

Garcia was 15 years old when he was diagnosed with Wilson’s disease, an inherited disorder in which there is too much copper in the body’s tissues, causing damage to the liver and nervous system. Garcia’s health was deteriorating quickly and he needed a liver transplant immediately. Becker’s donated liver helped to save Garcia’s life. Garcia is now a freshman at the University of San Francisco and an active Donate Life ambassador on organ donation.

The two families will reconnect again this Monday, Dec. 10, along with UCSF transplant staff and members of the California Transplant Donor Network to share their stories and complete decorating the floragraph of Becker.

WHEN:
Monday, Dec. 10, 2012
10 – 11 a.m.

WHERE:
UCSF Parnassus Campus Library – Teaching & Learning Center
530 Parnassus Ave, San Francisco
Room CL221

WHO: 

• Alfonso Garcia, former UCSF liver transplant patient
• Oscar and Marta Garcia, Alfonso’s parents
• Connie Mays and Rick Becker, parents of the former UCSF liver transplant donor, George Becker
• Ryutaro Hirose, M.D., UCSF professor of clinical surgery, Division of Transplant Surgery
• Sean Van Slyck, organ program director at California Transplant Donor Network

CONTACT: Media planning to attend should RSVP to Abigail Mortimore at abigail.mortimore@ucsf.edu or (415) 476-8810.

Related links:

• Rose Parade tribute to a Bruin who saved lives
• Two UCLA nurses are Rose Parade-bound

Portable power supply allows patient to go home while he awaits new heart.

Chad Washington with total artificial heart and pump device

Imagine living without a heart. It is possible — if you have a new artificial heart pumping blood through your body. You can even go to the supermarket, watch your kid’s soccer game or go on a hike.

Ronald Reagan UCLA Medical Center has performed its first procedure to remove a patient’s diseased heart and replace it with a SynCardia Temporary Total Artificial Heart.

Chad Washington, 35, underwent the seven-hour transplant surgery at UCLA on Oct. 29, led by Dr. Murray Kwon, an assistant professor of cardiothoracic surgery.

The temporary pump will act as a “bridge” until Washington receives a new donor heart.

“Historically, patients with a total artificial heart had to remain hospitalized while they waited for a transplant because they were tethered to a large machine to power the device,” Kwon said. “Today, however, this device can be powered by advanced technology small enough to fit in a backpack.”

“It sounds like a loud grandfather clock going ‘tick-tock’ in my chest, but it doesn’t feel foreign. It’s there to help,” Washington said of the artificial heart. “I’m so glad to be living in an age where technology is moving so fast.”

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UCSF transplant team produces a miracle for one young leukemia patient.

The Drake family, June 2012

As the parent of a bone marrow transplant patient, there are a few milestones that you long for your child to reach. Katie and Julian Drake were told that if their son Harry made it to six weeks post-transplant, he was in good shape. If he made it to six months, he was in really good shape. And if he made it to a year, well, he was golden.

Four years later, the Pediatric Blood and Marrow Transplant team at UC San Francisco Benioff Children’s Hospital calls Harry a miracle.

The team is widely known for making miracles happen: their efforts have helped Benioff Children’s Hospital rank among the top pediatric centers in the country for higher-than-expected patient survival following bone marrow transplants. In a recent review of 156 transplant centers nationwide, the Center for International Blood and Marrow Transplant Research estimated that the median chance for survival at one year post-transplant is 63.4 percent — compared with 87.6 percent at UCSF.

Knowing your child has cancer

On Nov. 27, 2007, Harry Drake came into the world. The much-anticipated second child of Katie and Julian, Harry was so easygoing that his somewhat reserved English parents went so far as to call him an angel.

In June 2008, the Drakes felt they had finally set a foot on the ladder to the good life. They were the owners of a new home and car, and had jobs they enjoyed. Their elder son, Jack, was an energetic 3-year-old. And at 6 months, Harry was starting to sleep through the night. The Drakes celebrated one Sunday with an outing to a nearby lake, stopping at their favorite ice cream shop on the way home.

But as Katie uploaded photos from the day to her computer that night, one picture in particular caught her eye: a shot of Harry with an odd bump on his head, about the size of a quarter and shaped like a horseshoe.

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Related link:
UCSF Magazine

Experimental technology could transform field of lung transplantation.
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First there was the “heart in a box,” a revolutionary experimental technology that allows donor hearts to be delivered to transplant recipients warm and beating rather than frozen in an ice cooler.

Now that same technology is being used to deliver “breathing lungs.”

The lung transplant team at Ronald Reagan UCLA Medical successfully performed the nation’s first “breathing lung” transplant in mid-November. The patient, a 57-year-old who suffered from pulmonary fibrosis — a disease in which the air sacs of the lungs are gradually replaced by scar tissue — received two new lungs and is recuperating from the seven-hour surgery.

TransMedics OCS lung transport device

The groundbreaking transplant involved an experimental organ-preservation device known as the Organ Care System (OCS), which keeps donor lungs functioning and “breathing” in a near-physiologic state outside the body during transport. The current standard involves transporting donor lungs in a non-functioning, non-breathing state inside an icebox.

With the OCS, the lungs are removed from a donor’s body and are placed in a high-tech OCS box, where they are immediately revived to a warm, breathing state and perfused with oxygen and a special solution supplemented with packed red-blood cells. The device also features monitors that display how the lungs are functioning during transport.

“Organs were never meant to be frozen on ice,” said Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of the heart and lung transplantation program at Ronald Reagan UCLA Medical Center. “Lungs are very sensitive and can easily be damaged during the donation process. The cold storage method does not allow for reconditioning of the lungs before transplantation, but this promising ‘breathing lung’ technology enables us to potentially improve the function of the donor lungs before they are placed in the recipient.”

UCLA is currently leading the U.S. arm of the international, multicenter phase 2 clinical INSPIRE study of the OCS, developed by medical device company TransMedics; Ardehali is the principal investigator for UCLA. The purpose of the trial is to compare donor lungs transported using the OCS technology with the standard icebox method. The INSPIRE trial is also underway at lung transplant centers in Europe, Australia and Canada and will enroll a total of 264 randomized patients.

According to Ardehali, in addition to potentially improving donor-lung function, the technology could help transplant teams better assess donor lungs, since the organs can be tested in the device, over a longer period of time.

In addition, it could help expand the donor pool by allowing donor lungs to be safely transported across longer distances.

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UCSF program gets high marks for patient outcomes in national survey.

The 10,911-foot view from the top of Cathedral Peak in Yosemite National Park is a familiar sight for Rowan Jimenez. The 44-year-old rock climber and musician has traversed this mountain many times before, but this particular attempt on a September day in 2010 was different: It marked a triumphant return on the two-year anniversary of his double lung transplant surgery.

“My friends thought I was crazy,” Jimenez said. “But I needed to do it. I needed to know that I still had my old life. I didn’t want to be content to just be sitting on a couch. That wouldn’t have worked for me.”

Jimenez was diagnosed with scleroderma, an autoimmune disease, in early 2008 after he constantly experienced shortness of breath.

“I just thought I was getting old,” he said. “I didn’t realize it was something more serious.”

The once energetic rock performer was tired and had difficulty catching his breath. He was in the early stage of lung failure.

Steven Hays examines Rowan Jimenez during one of his routine follow-up visits at UCSF Medical Center.

Jimenez went to UC San Francisco’s Lung Transplant Program, one of the top programs in the country, according to the Scientific Registry of Transplant Recipients. UCSF is among three out of 70 programs for “higher than expected” outcomes based on complex risk factors.

“The success of the program is multifactorial and a multidisciplinary effort that starts with excellent anesthetic management, meticulous surgical technique and perioperative surgical care, and long-term close surveillance,” said Jasleen Kukreja, M.D., M.P.H., surgical director of the UCSF Lung Transplant Program.

Jimenez credits UCSF for giving his life back. He was only on the lung transplantation list for seven weeks when he received a call to come in for surgery.

“I was shocked,” he said. “I didn’t think it could happen so fast. I felt very lucky.”

Jimenez started pre-surgery visits to get him ready for two new lungs.

“Rowan was one of the sicker patients I had ever seen coming into this office,” said Steven Hays, M.D., medical director of the UCSF Lung Transplant Program. “In fact, when I first met Rowan, I was worried we weren’t going to get his transplant done in time. He was that sick.”

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UCSF study finds transplant wait-list deaths are not just due to organ availability.

Jennifer Lai, UC San Francisco

Most liver transplant candidates who died or were removed from the transplant list actually received one or more liver donation offers, according to a recent UC San Francisco study.

“What we found challenges the simplistic view that transplant dynamics are driven simply by organ availability,” said lead author, Jennifer Lai, M.D., assistant clinical professor in the UCSF Division of Gastroenterology and Hepatology. “Efforts to reduce wait-list mortality must target all aspects of mismatch between supply and demand.” 

Recognized as a world leader in organ transplantation since 1964, the UCSF Organ Transplant Service has performed transplants for more than 10,000 patients and has played a key role in defining the field. The UCSF Liver Transplant Program, designated as a “Center of Excellence” by the U.S. Department of Health and Human Services, performs more liver transplants than any other hospital in Northern California – over 2,300 liver transplants for adults and children since it began in 1988.

For this study, the research team analyzed data from 33,389 candidates listed in the United Network for Organ Sharing (UNOS)/Organ Procurement and Transplantation Network (OPTN) registry during the time frame of Feb. 1, 2005, to Jan. 31, 2010. Out of the candidates who had died or been delisted, 84 percent received one or more liver offers prior to death/delisting, indicating that they had an opportunity to undergo transplantation. Reasons for liver offer refusals were reported as donor quality/age or other donor-related factors, size compatibility or recipient readiness.

“Understanding the real-time factors involved in the decisions regarding liver transplant offers is vital to improving the wait-list process,” said senior author, John Roberts, M.D., professor of surgery and chief of the UCSF Division of Transplantation. “While some of the factors are beyond control, others can be managed.”

Simply increasing the availability of deceased donor livers or the number of offers may not necessarily reduce wait-list mortality, according to the study, published in the leading journal in its field, Gastroenterology. Instead, the study suggests that efforts must be made to understand multiple factors involving candidates, donors and transplant centers to help influence what is often a complex and dynamic decision to accept or decline a liver offer.

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UC Davis, UCSF and UC San Diego transplant programs also recognized.

Abbas Ardehali, UCLA

The heart transplant program at Ronald Reagan UCLA Medical Center has again been recognized as one of highest ranking in the nation by an agency of the U.S. Department of Health and Human Services.

UCLA’s program is one of only seven heart transplant centers nationwide — and the only one in California — to be ranked at the silver level by the Health Resources and Services Administration (HRSA), which has federal oversight of the nation’s organ donation and transplantation network. HRSA also ranked UC Davis’ kidney transplant program and UC San Francisco’s lung transplant program at the silver level and ranked UC San Diego’s heart and kidney transplant programs at the bronze level.

The HRSA survey measures the performance of organ transplant centers by assessing transplant rates, post-transplant survival rates and mortality rates for patients after they are placed on organ-donation waiting lists. To earn silver status, a program must achieve better-than-expected performance in at least two of those categories. Only one center — a liver transplant program in Florida — earned a gold ranking for achievements in all three.

UCLA, which also earned silver status in 2010, when the HRSA organ transplant center survey was inaugurated, is the only heart transplant program in the U.S. to have earned a silver ranking twice.

“As the only two-time silver-level heart transplant program, we are incredibly proud of our team’s hard work in providing the very best care for our patients who undergo this lifesaving treatment,” said Dr. Abbas Ardehali, a professor of cardiothoracic surgery and director of UCLA’s heart transplant program. “This recognition acknowledges that patients in the UCLA heart transplant program have a better chance of survival.”

The HRSA awards were presented Oct. 4 at ceremony held in Grapevine, Texas.

In addition, Ronald Reagan UCLA Medical Center received the Department of Health and Human Services’ Bronze Medal of Honor for Organ Donation for achieving and sustaining national goals for organ donation, including a donation rate of 75 percent or more of eligible donors.

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