so how’s your kidney doing today you’re probably not thinking about your kidney
probably not thinking about your kidney
probably not thinking about your kidney you’re probably thinking about your
you’re probably thinking about your
you’re probably thinking about your bladder but not your kidney most of who
bladder but not your kidney most of who
bladder but not your kidney most of who you are is not what defines who you are
you are is not what defines who you are
you are is not what defines who you are most of who you think you are is what
most of who you think you are is what
most of who you think you are is what others think you are which in fact you
others think you are which in fact you
others think you are which in fact you would hope is who you really are
so who are we most people would say that
so who are we most people would say that we are what is conveyed through our
we are what is conveyed through our
we are what is conveyed through our faces our beliefs our celebrations our
faces our beliefs our celebrations our
faces our beliefs our celebrations our emotions we communicate with our hands
emotions we communicate with our hands
emotions we communicate with our hands in ways that are explicit any ways that
in ways that are explicit any ways that
in ways that are explicit any ways that are implicit and we also communicate
are implicit and we also communicate
are implicit and we also communicate with our voices
with our voices
with our voices usually aided by our hands on our face
usually aided by our hands on our face
usually aided by our hands on our face this is what most people would say
this is what most people would say
this is what most people would say that’s what we are
so who are they who do they think they
so who are they who do they think they are what voice is given to the voiceless
are what voice is given to the voiceless
are what voice is given to the voiceless and how does she communicate and what
and how does she communicate and what
and how does she communicate and what can we do for them it turns out quite a
can we do for them it turns out quite a
can we do for them it turns out quite a lot I entitled this dog human
lot I entitled this dog human
lot I entitled this dog human transplantation because that’s what I
transplantation because that’s what I
transplantation because that’s what I think we see a really is the field that
think we see a really is the field that
think we see a really is the field that I’m involved is in is called
I’m involved is in is called
I’m involved is in is called vascularized composite
vascularized composite
vascularized composite allotransplantation which is the
allotransplantation which is the
allotransplantation which is the transplantation of peripheral tissues
transplantation of peripheral tissues
transplantation of peripheral tissues like skin muscle bone nerve with the
like skin muscle bone nerve with the
like skin muscle bone nerve with the vascular supply as a functional unit
vascular supply as a functional unit
vascular supply as a functional unit like the hand I was born in Bogota
like the hand I was born in Bogota
like the hand I was born in Bogota Colombia my first language is a first
Colombia my first language is a first
Colombia my first language is a first language in Spanish and when I finished
language in Spanish and when I finished
language in Spanish and when I finished high school I won a scholarship by merit
high school I won a scholarship by merit
high school I won a scholarship by merit to do it my my international
to do it my my international
to do it my my international baccalaureate outside my country and I
baccalaureate outside my country and I
baccalaureate outside my country and I chose to go to imbibe and Swaziland in
chose to go to imbibe and Swaziland in
chose to go to imbibe and Swaziland in one of the three kingdoms in Africa I
one of the three kingdoms in Africa I
one of the three kingdoms in Africa I was the first Colombian at that college
was the first Colombian at that college
was the first Colombian at that college and we were 350 students from 72
and we were 350 students from 72
and we were 350 students from 72 different countries I change language I
different countries I change language I
different countries I change language I changed countries I change continents I
changed countries I change continents I
changed countries I change continents I change hemisphere and I changed the
change hemisphere and I changed the
change hemisphere and I changed the structure that I was used to studying I
structure that I was used to studying I
structure that I was used to studying I went on to finish my medical school in
went on to finish my medical school in
went on to finish my medical school in Mexico City and I’ve always been very
Mexico City and I’ve always been very
Mexico City and I’ve always been very interested in doing research
interested in doing research
interested in doing research I like understanding and answering
I like understanding and answering
I like understanding and answering questions in a scientific way so the
questions in a scientific way so the
questions in a scientific way so the last year of my medical school I chose
last year of my medical school I chose
last year of my medical school I chose to do it in immunology or a mythology
to do it in immunology or a mythology
to do it in immunology or a mythology and a patient was who inspire me to
and a patient was who inspire me to
and a patient was who inspire me to think for the first time about a hand
think for the first time about a hand
think for the first time about a hand transplant at the time I didn’t know
transplant at the time I didn’t know
transplant at the time I didn’t know anybody
anybody
anybody who
who
who than a hand transplant I hadn’t heard
than a hand transplant I hadn’t heard
than a hand transplant I hadn’t heard about a hand transplant I hadn’t spoken
about a hand transplant I hadn’t spoken
about a hand transplant I hadn’t spoken with anybody about how transplantation
with anybody about how transplantation
with anybody about how transplantation and years later I was fortunate to be in
and years later I was fortunate to be in
and years later I was fortunate to be in the first hand team that performed the
the first hand team that performed the
the first hand team that performed the first hand transplant and the second
first hand transplant and the second
first hand transplant and the second hand transplant in the United States but
hand transplant in the United States but
hand transplant in the United States but like any mere field like any new field
like any mere field like any new field
like any mere field like any new field we have scientific questions why were
we have scientific questions why were
we have scientific questions why were the animals to study these stitches how
the animals to study these stitches how
the animals to study these stitches how do we talk to each other when we do our
do we talk to each other when we do our
do we talk to each other when we do our research and how how can can we can we
research and how how can can we can we
research and how how can can we can we communicate our findings
communicate our findings
communicate our findings what anti-rejection medication do we use
what anti-rejection medication do we use
what anti-rejection medication do we use what is the life how is the reason
what is the life how is the reason
what is the life how is the reason benefit ratio and the safe
benefit ratio and the safe
benefit ratio and the safe implementation of this field in this
implementation of this field in this
implementation of this field in this country and what are the functional
country and what are the functional
country and what are the functional outcomes and these have been the areas
outcomes and these have been the areas
outcomes and these have been the areas that I have been focusing in my career
that I have been focusing in my career
that I have been focusing in my career so we establish an animal model in
so we establish an animal model in
so we establish an animal model in rodents to study the mechanisms of how
rodents to study the mechanisms of how
rodents to study the mechanisms of how all these tissues behave after
all these tissues behave after
all these tissues behave after transplantation we also establish a
transplantation we also establish a
transplantation we also establish a nonhuman primate model that follows the
nonhuman primate model that follows the
nonhuman primate model that follows the high ethical requirements for
high ethical requirements for
high ethical requirements for experimentation and these animals even
experimentation and these animals even
experimentation and these animals even in the case of graph loss when we
in the case of graph loss when we
in the case of graph loss when we transplant the skin and the bone and the
transplant the skin and the bone and the
transplant the skin and the bone and the tendon and the nerve they do not lose
tendon and the nerve they do not lose
tendon and the nerve they do not lose any function but it allows us this model
any function but it allows us this model
any function but it allows us this model allows us to test biologic that are very
allows us to test biologic that are very
allows us to test biologic that are very specific to human with human specificity
specific to human with human specificity
specific to human with human specificity which is the only way to do it with this
which is the only way to do it with this
which is the only way to do it with this model we have been able to study not
model we have been able to study not
model we have been able to study not only the behavior of the tissues but we
only the behavior of the tissues but we
only the behavior of the tissues but we have been able to study a new medication
have been able to study a new medication
have been able to study a new medication that we have learned from
that we have learned from
that we have learned from transplantation that works in hynny
transplantation that works in hynny
transplantation that works in hynny transplantation that is called Bella
transplantation that is called Bella
transplantation that is called Bella Tasha we have been the first to show
Tasha we have been the first to show
Tasha we have been the first to show that this medication prevents rejection
that this medication prevents rejection
that this medication prevents rejection in non-human primates in this type of
in non-human primates in this type of
in non-human primates in this type of transplant and have also been the first
transplant and have also been the first
transplant and have also been the first to show that this medication prevents
to show that this medication prevents
to show that this medication prevents rejection
rejection
rejection in human hand transplantation in
in human hand transplantation in
in human hand transplantation in patients that have received hands we
patients that have received hands we
patients that have received hands we didn’t have a common language in which
didn’t have a common language in which
didn’t have a common language in which to report our results so we gather
to report our results so we gather
to report our results so we gather investigators from around the world who
investigators from around the world who
investigators from around the world who had performed a clinical BCA
had performed a clinical BCA
had performed a clinical BCA and through consensus discussions we
and through consensus discussions we
and through consensus discussions we develop a scoring system to report
develop a scoring system to report
develop a scoring system to report rejection in the skin and now is a
rejection in the skin and now is a
rejection in the skin and now is a common language that all teams around
common language that all teams around
common language that all teams around the world use to report their results it
the world use to report their results it
the world use to report their results it is important to do this with real
is important to do this with real
is important to do this with real careful thought I was fortunate to be
careful thought I was fortunate to be
careful thought I was fortunate to be the inaugural committee chair for the
the inaugural committee chair for the
the inaugural committee chair for the American Society of transplant surgeons
American Society of transplant surgeons
American Society of transplant surgeons and we put forward recommendations to
and we put forward recommendations to
and we put forward recommendations to add this type of transplant under the
add this type of transplant under the
add this type of transplant under the definition of solid organ
definition of solid organ
definition of solid organ transplantation and the final rule came
transplantation and the final rule came
transplantation and the final rule came out and now I serve in the committee at
out and now I serve in the committee at
out and now I serve in the committee at unis developing the guidelines for a
unis developing the guidelines for a
unis developing the guidelines for a safe implementation of this type of
safe implementation of this type of
safe implementation of this type of transplant in the country this is one of
transplant in the country this is one of
transplant in the country this is one of the most complex things you could ever
the most complex things you could ever
the most complex things you could ever imagine
these is clinical research at its finest
these is clinical research at its finest and the only way to do it is based on
and the only way to do it is based on
and the only way to do it is based on our very strong multidisciplinary
our very strong multidisciplinary
our very strong multidisciplinary approach and we have a Duke and people
approach and we have a Duke and people
approach and we have a Duke and people ask me how big is your team and my
ask me how big is your team and my
ask me how big is your team and my answer is half of Duke University
this is a low-volume type of research or
this is a low-volume type of research or application we also collaborate
application we also collaborate
application we also collaborate nationally we lead the consortium on VCA
nationally we lead the consortium on VCA
nationally we lead the consortium on VCA we collaborate with five outstanding
we collaborate with five outstanding
we collaborate with five outstanding institutions around the country who also
institutions around the country who also
institutions around the country who also have a preclinical and a clinical
have a preclinical and a clinical
have a preclinical and a clinical setting for the study of ECA so we stick
setting for the study of ECA so we stick
setting for the study of ECA so we stick to good scientific principles but we
to good scientific principles but we
to good scientific principles but we shouldn’t lose track of what these can’t
shouldn’t lose track of what these can’t
shouldn’t lose track of what these can’t really do as an example let me share
really do as an example let me share
really do as an example let me share with you one of my cases miss el who has
with you one of my cases miss el who has
with you one of my cases miss el who has given me consent to share the story miss
given me consent to share the story miss
given me consent to share the story miss l lost her left hand on both her lower
l lost her left hand on both her lower
l lost her left hand on both her lower extremities when she was four months old
when she turned 21 she was getting ready
when she turned 21 she was getting ready to go and celebrate with her friends her
to go and celebrate with her friends her
to go and celebrate with her friends her 21st birthday and as she wrote to me my
21st birthday and as she wrote to me my
21st birthday and as she wrote to me my prosthesis broke again and she couldn’t
prosthesis broke again and she couldn’t
prosthesis broke again and she couldn’t go out she went onto the website a three
go out she went onto the website a three
go out she went onto the website a three o’clock in the morning on that Saturday
o’clock in the morning on that Saturday
o’clock in the morning on that Saturday and sent me an email looking for an
and sent me an email looking for an
and sent me an email looking for an option to change her life I spoke with
option to change her life I spoke with
option to change her life I spoke with her the very same day she went through a
her the very same day she went through a
her the very same day she went through a very thorough evaluation and after
very thorough evaluation and after
very thorough evaluation and after months she went on the waiting list and
months she went on the waiting list and
months she went on the waiting list and after months of being on the waiting
after months of being on the waiting
after months of being on the waiting list a gracious family donated a hand
list a gracious family donated a hand
list a gracious family donated a hand for her it took us 19 hours to do the
for her it took us 19 hours to do the
for her it took us 19 hours to do the surgery
and every time I do this and I can do
and every time I do this and I can do this a million times I will never stop
this a million times I will never stop
this a million times I will never stop feeling thrill when I see someone’s hand
feeling thrill when I see someone’s hand
feeling thrill when I see someone’s hand come back we match for skin pigmentation
come back we match for skin pigmentation
come back we match for skin pigmentation sex blood type and size they go through
sex blood type and size they go through
sex blood type and size they go through extensive therapy and she used to spend
extensive therapy and she used to spend
extensive therapy and she used to spend hours looking at her new body image and
hours looking at her new body image and
hours looking at her new body image and I used to think I wonder what she’s
I used to think I wonder what she’s
I used to think I wonder what she’s thinking I don’t know what she was
thinking I don’t know what she was
thinking I don’t know what she was thinking but she allowed us to learn
thinking but she allowed us to learn
thinking but she allowed us to learn that for somebody who loses the hand at
that for somebody who loses the hand at
that for somebody who loses the hand at four months of age and gets a hand
four months of age and gets a hand
four months of age and gets a hand husband at 21 years old the area in the
husband at 21 years old the area in the
husband at 21 years old the area in the brain where that hand was represented
brain where that hand was represented
brain where that hand was represented initially that they didn’t have a
initially that they didn’t have a
initially that they didn’t have a presentation for 21 years
presentation for 21 years
presentation for 21 years it comes back after 54 days
she went like all these patients through
she went like all these patients through a very extensive rehabilitation
a very extensive rehabilitation
a very extensive rehabilitation occupational therapy so the therapies
occupational therapy so the therapies
occupational therapy so the therapies used to do his/her therapy from Monday
used to do his/her therapy from Monday
used to do his/her therapy from Monday through Friday and because the studies
through Friday and because the studies
through Friday and because the studies have shown that the more occupational
have shown that the more occupational
have shown that the more occupational therapy they do within the first three
therapy they do within the first three
therapy they do within the first three to six months the better the outcome I
to six months the better the outcome I
to six months the better the outcome I used to do her therapy on Saturday
used to do her therapy on Saturday
used to do her therapy on Saturday mornings
mornings
mornings that gave us a very nice opportunity to
that gave us a very nice opportunity to
that gave us a very nice opportunity to also learn about each other and it was
also learn about each other and it was
also learn about each other and it was time you know in our conversations to
time you know in our conversations to
time you know in our conversations to learn she learned that I like brownies
and when the therapist asked her what
and when the therapist asked her what was the activity that she wanted to
was the activity that she wanted to
was the activity that she wanted to translate to in anticipation for going
translate to in anticipation for going
translate to in anticipation for going back home
back home
back home the first occupational activity she made
the first occupational activity she made
the first occupational activity she made brownies for me
brownies for me
brownies for me needless to say these are the most
needless to say these are the most
needless to say these are the most special brownies I’ve ever tasted she
special brownies I’ve ever tasted she
special brownies I’ve ever tasted she now uses her hand in distinctively she
now uses her hand in distinctively she
now uses her hand in distinctively she has played golf for the first time in
has played golf for the first time in
has played golf for the first time in her life she has played baseball for the
her life she has played baseball for the
her life she has played baseball for the first time in her life she has played
first time in her life she has played
first time in her life she has played the guitar for the first time in her
the guitar for the first time in her
the guitar for the first time in her life if you ask her who she was he was
life if you ask her who she was he was
life if you ask her who she was he was not her kidney it was not her liver it
not her kidney it was not her liver it
not her kidney it was not her liver it wasn’t even her hand it was her ability
wasn’t even her hand it was her ability
wasn’t even her hand it was her ability to do what she wanted to do and how she
to do what she wanted to do and how she
to do what she wanted to do and how she felt about herself at the end of the day
felt about herself at the end of the day
felt about herself at the end of the day that’s why we’re here and that’s why we
that’s why we’re here and that’s why we
that’s why we’re here and that’s why we do research
do research
do research [Applause]
”
Be First to Comment