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[title] => Ugledni kardiokirurg prof. dr. Bojan Biočina o presađivanju svinjskog srca u čovjeka: ‘To bi mogao biti povijesni pothvat kojim bi se smanjile ogromne liste čekanja‘
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Tim vrhunskih liječnika sa američkog Sveučilišta Maryland Medicine uspio je pacijentu u terminalnoj fazi bolesti presaditi genetski modificirano srce svinje. Osmosatna operacija obavljena je u petak u Baltimoreu, a pacijent David Bennett (57) jučer se osjećao dobro. Ova transplantacija srca obavljena je samo nekoliko mjeseci nakon što su kirurzi u New Yorku uspješno na čovjeka transplantirali bubreg genetski modificirane svinje.
Američki mediji prenose izjavu operiranog pacijenta Davida Bennetta koji je prije presađivanja poručio: „Bilo je pitanje ili umrijeti ili napraviti ovu transplantaciju. Želim živjeti i to je moj posljednji izbor“.
Prof. dr. Bojan Biočina predstojnik Klinike za kardijalnu kirurgiju KBC-a Zagreb, koji je tijekom svoje karijere započeo, ili sudjelovao u nizu pionirskih ostvarenja u kardiokirurgiji u Hrvatskoj, primjerice bio je u timu prve transplantacije srca, prve potpune arterijske revaskularizacije miokarda, osnivanju prve banke kardiovaskularnog tkiva u Hrvatskoj i drugih, dobro je upoznat sa najnovijim znanstvenim dostignućem kolega iz SAD-a. Štoviše, dok je početkom devedesetih godina bio na specijalizaciji u Cambridgeu, tamo je upravo započinjao novi znanstveni program 'ubacivanja' ljudskih gena u svinje.
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Kaže nam kako je riječ o doista revolucionarnom zahvatu koji bi, ako uspije mogao nadomjestiti manjak donatorskih ljudskih organa. Podsjeća na to kako nema dovoljno ljudskih srca u donatorskim zalihama i da se ni blizu ne mogu ispuniti potrebe dugačke liste pacijenata koji ih trebaju. Ako bi ovo presađivanje modificiranog srca svinje uspjelo, približili bi se stepenicu bliže rješavanju problema nedostatka vitalnih ljudskih organa.
- Godišnje se u svijetu napravi 5.000 presađivanja srca, a potrebe su daleko, daleko veće, milijunske. Životi se spašavaju i presađivanjem umjetnog srca, i mi to radimo, ali mehanička pumpa ima određene limite. Ovo bi bilo sjajno rješenje pod uvjetom da je imunološki kompatibilno. Ideja je, dovoljno modificirati genetiku svinje da se imunološka reakcija oslabi. Toliko da se može kontrolirati nekim razumnim dozama lijekova. E, sad jesu li to kolege iz SAD-a postigle, tek ćemo vidjeti. Treba proći duže vrijeme da bi se vidjelo hoće li pacijent odbaciti presađeno srce – navodi dr. Biočina.
- Zašto baš svinje? - pitamo, a profesor odgovara kako su anatomija i fiziologija srca svinje najsličnije ljudskoj, pa ih zato koriste kao modele za razvoj novih liječenja.
Prisjetio se i dana provedenih na Sveučilištu u Cambridgeu gdje je promatrao ta istraživanja.
- Tadašnja tehnologija bila je krajnje jednostavna, za današnje doba mogli bismo reći i prilično primitivna. Ručno su se dijelovi jezgre stanice ubacivali u jajnu stanicu svinje, pa se to dalje križalo, a modificirano srce presađivalo majmunima. Postigli su se prvi rezultati, međutim tadašnja tehnologija nije uspijevala premostiti druge probleme u prvom redu one imunološke - priča ugledni liječnik.
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Dodaje i kako postoje mnoge prepreke koje treba prevladati prije nego što se takav postupak može naširoko primijeniti jer se odbacivanje organa događa čak i kada se transplantira dobro usklađeni organ ljudskog donora.
Pacijent operiran u Baltimoru posebno se nadzire i zbog infekcija, kao što je svinjski retrovirus koji se može prenijeti na ljude. Dr. Biočina kaže kako je sam postupak presađivanja srca za iskusne liječnike tehnički lako izvediv, no komplikacije naknadno stvaraju imunološki problemi.
- Već od prije je poznat taj problem sa svinjskim retrovirusima, ali nadam se da su kolege iz SAD-a uspjele naći neku tehniku kojom to kontroliraju, nada se dr. Biočina.
Svinja čije je srce presađeno u Bennetta imala je 10 genetskih modifikacija. Četiri gena su inaktivirana, uključujući i gen zbog kojeg ljudsko tijelo odbacuje organ. Inaktiviran je i gen zaslužan za rast, kako bi se spriječilo da svinjsko srce nastavi rasti nakon što je implantirano. Osim toga, šest ljudskih gena umetnuto je u genom svinje donora, a modifikacije su osmišljene kako bi svinjski organ bio podnošljiviji za ljudski imunološki sustav. Tim je koristio i novi eksperimentalni lijek kako bi suzbio Bennettov imunološki sustav i spriječio odbacivanje organa. Također je koristio novi stroj za perfuziju kako bi svinjsko srce bilo prokrvljeno i tako se sačuvalo do operacije.
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Dr. Biočina podsjeća kako je prvu transplataciju svinjskog srca na čovjeka napravio 1985. godine poljski kardiokirurg prof. Zbigniew Religa. On je koristio obično, a ne modificirano srce svinje i pacijent nije preživio duže od 24 sata. Zbigniew Religa tada je pobrao brojne kritike kako je to bio neetički postupak.
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Tim vrhunskih liječnika sa američkog Sveučilišta Maryland Medicine uspio je pacijentu u terminalnoj fazi bolesti presaditi genetski modificirano srce svinje. Osmosatna operacija obavljena je u petak u Baltimoreu, a pacijent David Bennett (57) jučer se osjećao dobro. Ova transplantacija srca obavljena je samo nekoliko mjeseci nakon što su kirurzi u New Yorku uspješno na čovjeka transplantirali bubreg genetski modificirane svinje.
Američki mediji prenose izjavu operiranog pacijenta Davida Bennetta koji je prije presađivanja poručio: „Bilo je pitanje ili umrijeti ili napraviti ovu transplantaciju. Želim živjeti i to je moj posljednji izbor“.
Prof. dr. Bojan Biočina predstojnik Klinike za kardijalnu kirurgiju KBC-a Zagreb, koji je tijekom svoje karijere započeo, ili sudjelovao u nizu pionirskih ostvarenja u kardiokirurgiji u Hrvatskoj, primjerice bio je u timu prve transplantacije srca, prve potpune arterijske revaskularizacije miokarda, osnivanju prve banke kardiovaskularnog tkiva u Hrvatskoj i drugih, dobro je upoznat sa najnovijim znanstvenim dostignućem kolega iz SAD-a. Štoviše, dok je početkom devedesetih godina bio na specijalizaciji u Cambridgeu, tamo je upravo započinjao novi znanstveni program 'ubacivanja' ljudskih gena u svinje.
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Kaže nam kako je riječ o doista revolucionarnom zahvatu koji bi, ako uspije mogao nadomjestiti manjak donatorskih ljudskih organa. Podsjeća na to kako nema dovoljno ljudskih srca u donatorskim zalihama i da se ni blizu ne mogu ispuniti potrebe dugačke liste pacijenata koji ih trebaju. Ako bi ovo presađivanje modificiranog srca svinje uspjelo, približili bi se stepenicu bliže rješavanju problema nedostatka vitalnih ljudskih organa.
- Godišnje se u svijetu napravi 5.000 presađivanja srca, a potrebe su daleko, daleko veće, milijunske. Životi se spašavaju i presađivanjem umjetnog srca, i mi to radimo, ali mehanička pumpa ima određene limite. Ovo bi bilo sjajno rješenje pod uvjetom da je imunološki kompatibilno. Ideja je, dovoljno modificirati genetiku svinje da se imunološka reakcija oslabi. Toliko da se može kontrolirati nekim razumnim dozama lijekova. E, sad jesu li to kolege iz SAD-a postigle, tek ćemo vidjeti. Treba proći duže vrijeme da bi se vidjelo hoće li pacijent odbaciti presađeno srce – navodi dr. Biočina.
- Zašto baš svinje? - pitamo, a profesor odgovara kako su anatomija i fiziologija srca svinje najsličnije ljudskoj, pa ih zato koriste kao modele za razvoj novih liječenja.
Prisjetio se i dana provedenih na Sveučilištu u Cambridgeu gdje je promatrao ta istraživanja.
- Tadašnja tehnologija bila je krajnje jednostavna, za današnje doba mogli bismo reći i prilično primitivna. Ručno su se dijelovi jezgre stanice ubacivali u jajnu stanicu svinje, pa se to dalje križalo, a modificirano srce presađivalo majmunima. Postigli su se prvi rezultati, međutim tadašnja tehnologija nije uspijevala premostiti druge probleme u prvom redu one imunološke - priča ugledni liječnik.
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Dodaje i kako postoje mnoge prepreke koje treba prevladati prije nego što se takav postupak može naširoko primijeniti jer se odbacivanje organa događa čak i kada se transplantira dobro usklađeni organ ljudskog donora.
Pacijent operiran u Baltimoru posebno se nadzire i zbog infekcija, kao što je svinjski retrovirus koji se može prenijeti na ljude. Dr. Biočina kaže kako je sam postupak presađivanja srca za iskusne liječnike tehnički lako izvediv, no komplikacije naknadno stvaraju imunološki problemi.
- Već od prije je poznat taj problem sa svinjskim retrovirusima, ali nadam se da su kolege iz SAD-a uspjele naći neku tehniku kojom to kontroliraju, nada se dr. Biočina.
Svinja čije je srce presađeno u Bennetta imala je 10 genetskih modifikacija. Četiri gena su inaktivirana, uključujući i gen zbog kojeg ljudsko tijelo odbacuje organ. Inaktiviran je i gen zaslužan za rast, kako bi se spriječilo da svinjsko srce nastavi rasti nakon što je implantirano. Osim toga, šest ljudskih gena umetnuto je u genom svinje donora, a modifikacije su osmišljene kako bi svinjski organ bio podnošljiviji za ljudski imunološki sustav. Tim je koristio i novi eksperimentalni lijek kako bi suzbio Bennettov imunološki sustav i spriječio odbacivanje organa. Također je koristio novi stroj za perfuziju kako bi svinjsko srce bilo prokrvljeno i tako se sačuvalo do operacije.
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Dr. Biočina podsjeća kako je prvu transplataciju svinjskog srca na čovjeka napravio 1985. godine poljski kardiokirurg prof. Zbigniew Religa. On je koristio obično, a ne modificirano srce svinje i pacijent nije preživio duže od 24 sata. Zbigniew Religa tada je pobrao brojne kritike kako je to bio neetički postupak.
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[socialLink] => https%3A%2F%2Fslobodnadalmacija.hr%2Fmozaik%2Fpanorama%2Fugledni-kardiokirurg-prof-dr-bojan-biocina-o-presadivanju-svinjskog-srca-u-covjeka-to-bi-mogao-biti-povijesni-pothvat-kojim-bi-se-smanjile-ogromne-liste-cekanja-1158312
)
Array
(
[1] => stdClass Object
(
[id] => 2
[name] => Superscript Title
[value] => Revolucionarni zahvat
[type] => textarea
[group] => 9
[published] => 1
[ordering] => 2
[alias] => SuperscriptTitle
)
[3] => stdClass Object
(
[id] => 61
[name] => Contains Infographic
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 4
[alias] => contains_infographic
)
[4] => stdClass Object
(
[id] => 62
[name] => Without ads
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 5
[alias] => Withoutads
)
[5] => stdClass Object
(
[id] => 63
[name] => Photo gallery
[value] => ON
[type] => radio
[group] => 9
[published] => 1
[ordering] => 6
[alias] => Photo_gallery
)
[6] => stdClass Object
(
[id] => 64
[name] => Promo
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 7
[alias] => promo
)
[8] => stdClass Object
(
[id] => 67
[name] => Contains video
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 9
[alias] => contains_video
)
[9] => stdClass Object
(
[id] => 68
[name] => Premium content
[value] => ON
[type] => radio
[group] => 9
[published] => 1
[ordering] => 10
[alias] => premium_content
)
[10] => stdClass Object
(
[id] => 69
[name] => Exclude comments
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 11
[alias] => exclude_comments
)
[11] => stdClass Object
(
[id] => 70
[name] => Open link in new window
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 12
[alias] => open_link_in_new_window
)
[12] => stdClass Object
(
[id] => 71
[name] => Horizontal crop of the main photo
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 13
[alias] => horizontal_crop_of_the_main_photo
)
[13] => stdClass Object
(
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[name] => No-index
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 15
[alias] => no_index
)
[14] => stdClass Object
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[id] => 74
[name] => No-cache
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 16
[alias] => no_cache
)
[15] => stdClass Object
(
[id] => 77
[name] => Don't show on the front page
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 17
[alias] => dont_show_on_the_front_page
)
[16] => stdClass Object
(
[id] => 78
[name] => Related on bottom
[value] => ON
[type] => radio
[group] => 9
[published] => 1
[ordering] => 18
[alias] => related_on_bottom
)
[17] => stdClass Object
(
[id] => 79
[name] => Live button
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 19
[alias] => live_button
)
[26] => stdClass Object
(
[id] => 87
[name] => Instant articles
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 28
[alias] => instant_articles
)
[27] => stdClass Object
(
[id] => 91
[name] => S preporučuje
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 29
[alias] => s_preporucuje
)
[28] => stdClass Object
(
[id] => 92
[name] => S voli
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 30
[alias] => s_voli
)
[29] => stdClass Object
(
[id] => 93
[name] => Layout with three photos
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 31
[alias] => layout_with_three_photos
)
[30] => stdClass Object
(
[id] => 94
[name] => Gallery in the article
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 32
[alias] => gallery_in_the_article
)
[31] => stdClass Object
(
[id] => 95
[name] => Required views
[value] => 0
[type] => textfield
[group] => 9
[published] => 1
[ordering] => 33
[alias] => required_views
)
[32] => stdClass Object
(
[id] => 96
[name] => FullHD image
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 34
[alias] => fullhd_image
)
[33] => stdClass Object
(
[id] => 98
[name] => Paid Article
[value] => OFF
[type] => radio
[group] => 9
[published] => 1
[ordering] => 36
[alias] => paid_article
)
)
17. svibanj 2024 13:24
