Dawn of Tissue Engineering Pathology and

The End of Transplantation Waiting Lists

Current Problem

Donor organ transplant currently gold standard for end stage organ failure

BUTThis only provides new organs to 10% of

patients in need

Current Problem

Thousands of patients die without ever having a chance for transplant

Solution:Tissue Engineered Organs

Functional organs made from stem cellsWill completely eliminate need for donor

organs

TE organs = 100% availability of organ transplantation for everyone in need

Future Has Arrived

Current Successes of TE Organs- Semi Synthetic Scaffolds used in

Tracheobronchial transplantation,- Esophagus, Bladder transplant- Viacyte VC-01 Combination product used to

replace pancreas in Type 1 Diabetes Patients

Success of TE

Provide more opportunity for this

Critical Role of Pathologists in TE field

TE organs won't always come out perfectPathologists must identify abnormalities

Types of Abnormalities

“One off” abnormalities. Seen only once, caused by certain engineering techniques

Repeating abnormalities will form the bulk of what Pathologists see and look for

Repeating Abnormalities

Repeating Abnormalities Missing Cells/Structures, Loop of Henle missing

Chang C.H. &

Davies J.A. kidneys

from re-aggregated fetal cells fetal cells

Rejection Unlikely

Since patients own stem cells are being used, TE organ will be syngeneic

But Don't Forget

TE Organs will be subject to conventional diseases too

Therefore Pathologists will have double the number of diagnostic possibilities when it comes to TE organs!

Classifying TE Pathologies

Classification based on abnormalities and their ability to disrupt TE organ function

Benign criteria vs Potentially Lethal Criteria

Benign Criteria

Will not severely affect TE organ function or will not affect organ at all.

Will be safe to use TE organ in patient

Potentially Lethal Criteria

Severely affects TE organ function. Cause acute/chronic TE organ failureDeemed unfit for transplantation into patient

Use of Point System

Benign Criteria (-) pointsPotentially Lethal Criteria (+) points Sum of points = Class variantPoint threshold for “Danger Zone,”

“Borderline,” “Safe Zone,” etc.

Algorithms for Quantifiable Data

Tissue Engineering Medicine will offer true quantification

Biomarkers are quantifiable by nature Morphometry now a feasible way to assess

tissue

Algorithms for Quantifiable Data

Arbitrary scales will no longer be used. Computers can now create classification

algorithms from “Big Data” mining programs Previous classifications (I.E. Banff

Classification) were only semi quantifiable and therefore relied on subjective discretion of Pathologists

Assessing TE Organ Health with Surrogate Markers

Physically cutting into some TE organs (I.E. Bioreactors) is too invasive, therefore out of the question!

Biomarkers are non-invasive and easily observed in fluid around TE organ cells

Assessing TE Organ Health with Surrogate Markers

Kidney Injury Molecule-1 (KIM-1) recognized for it's ability to assess tubule injury

Bringing TE Into the MainstreamAdvocacy is key!Courses on future medical practices requiredTechnology and Future of Medicine course

taught at University of Alberta

Bringing TE Into the Mainstream

Pioneers of TE organs will become experts Will teach future generations

Advocate for TE Organs

Be at the forefront of the new dawn of medicine!

Questions

Thank you for your time