Signals From [Transplant] - PT03: The Technology
15 Signals transforming the art and science of organ transplantation
Welcome back to Signals From [Space], the place to discover what's next in healthcare technology— and who’s building it — one [space] at a time. I’m a founder and patient sharing my curiosities and earned wisdom along the way.
Organ transplantation is a life-saving medical advancement and monumental feat of human ingenuity.
Yet nearly 55 million Americans alive today were born at a time when transplantation was little more than a figment of imagination.
That's because, in the grand timeline of surgery, transplantation is still in its infancy. If the entire 12,000-year history of surgery were compressed into a single year, organ transplantation would have only come into being on December 29th.
Fast forward to the present, we've just marked the one millionth transplant in the United States, setting a dizzying pace of over 70 transplants per day. Despite this achievement, we must recognize there's still room for significant improvement, from public policy to health equity.
Fortunately, we are living in an era where the pace of technological innovation often seems indistinguishable from magic.
These two paths— the evolution of transplantation and the rise of technological innovations—have now converged, setting the stage for the next phase of exponential progress.
Here are 15 technologies across the transplant care journey I'm excited to track over the next decade:
Pre-Transplant
1. Community-based Patient Education
Enhancing health literacy and activation for patients awaiting transplant by providing them with the knowledge, skills, and confidence needed to navigate their journey successfully.
Examples include HealthUnlocked, Phreesia, and a number of organizations providing group-based education like ReMend, Lyfebulb, and IKONA. HealthUnlocked is the world’s largest social network for health, where patients can connect with others facing similar situations, share experiences, and access educational resources, leading to more informed decisions throughout their transplant journey.1
2. Donor Management
Advanced systems and software for donor identification, matching, organ procurement and delivery.
Innovations in this field include companies like Paragonix that offer advanced organ preservation and transport solutions, LifeNet Health providing leading-edge organ recovery technologies, and inVita offering software to streamline donor identification, matching, and procurement processes. These advancements contribute to more efficient organ allocation and increased transplant success rates.2
3. Diagnostics
Advancements in genomic and proteomic technologies are leading to more precise diagnostics, optimizing donor-recipient matching, and predicting transplant outcomes.
Companies like CareDx are at the forefront of leveraging genomic data for more accurate diagnostics, enhancing the donor-recipient matching process, and predicting transplant outcomes. Similarly, Natera utilizes molecular diagnostics to improve post-transplant monitoring and management, contributing to better patient care and transplant success. These advancements in genomic and proteomic technologies are revolutionizing the field by enabling more personalized and precise approaches to transplantation diagnostics.3
4. Precision Medicine
With tools that guide personalized immuno-suppressive therapy and assess an individual's risk of organ rejection, precision medicine is setting a new standard for tailored treatment strategies.
Companies such as GenDx (now part of Eurobio Scientific) are leading the way in precision medicine by offering comprehensive HLA typing solutions that enable more accurate donor-recipient matching, improving the success of transplants. Similarly, Immucor (now part of Werfen) specializes in providing molecular and serological solutions to enhance compatibility testing and support personalized treatment strategies. These advancements exemplify how precision medicine is revolutionizing transplantation by tailoring therapies to individual patients and optimizing transplant outcomes.4
In The OR
5. Regenerative Medicine
The bioengineering of organs and tissues in the lab holds enormous potential to address the critical issue of organ shortage.
Companies like Miromatrix are at the forefront of regenerative medicine, utilizing techniques to bioengineer organs and tissues outside the body. Additionally, Organovo focuses on 3D bioprinting technology to create functional tissues for transplantation. These advancements have the potential to revolutionize the field of transplantation by offering a renewable and scalable solution to the critical issue of organ shortage.5
6. Artificial and Bioprinted Organs
Artificial organs, xenotransplantation, 3D bioprinting could change entire supply equation, potentially eliminating the need for donor organs altogether.
Companies like BiVACOR are engineering innovative artificial hearts that could provide a viable alternative to traditional donor hearts. Additionally, Cellink is a leader in bioprinting technology, creating functional tissues and potentially whole organs through 3D printing techniques. These advancements hold the potential to transform the transplant field by offering alternatives to donor organs and addressing the critical issue of organ shortage.6
7. Ex Vivo Organ Perfusion
Advanced organ preservation systems are increasing organ viability during transport and even allowing for organ repair before transplantation.
Companies like OrganOx and TransMedics offer innovative ex vivo organ perfusion systems that enhance organ viability during transport, allowing for extended preservation periods and potential organ repair before transplantation. These advancements contribute to improved transplant outcomes by ensuring organs remain in optimal condition, expanding the donor pool, and reducing the risk of complications post-transplant.7
8. Robotic-Assisted Surgery
The use of robotic systems in transplant surgery is improving surgical precision and enabling less invasive procedures.
Companies like Intuitive Surgical have developed the da Vinci Surgical System, which is widely used in various surgical procedures, including kidney transplantation. This robotic system enhances surgical precision and enables minimally invasive procedures, leading to reduced trauma for patients, shorter hospital stays, and faster recovery times.8
9. Real-Time Navigation
Innovative imaging and navigation systems are providing surgeons with real-time insights during surgery, improving outcomes.
Companies like Stryker and Medivis offer advanced surgical navigation systems like the StealthStation™ and SurgicalAR, respectively. These systems provide surgeons with real-time insights during procedures, enhancing precision and decision-making. In transplantation, these technologies enable surgeons to navigate complex anatomies more accurately, leading to improved surgical outcomes and patient safety.910
10. Surgical Training
Virtual reality and other advanced training tools are enhancing the skillset of transplant surgeons, leading to improved patient outcomes despite surgeon shortages.
Companies like Osso VR and Level Ex are harnessing the power of virtual reality to provide surgeons with advanced training tools. These tools enable surgeons to enhance their skills in a realistic virtual environment, contributing to the development of a highly skilled transplant surgical workforce. By offering immersive training experiences, these technologies empower surgeons to improve patient outcomes and ensure the continued growth of expertise in the field of transplantation, even in the face of surgeon shortages.11
Post-Transplant
11. Telemedicine and Remote Patient Monitoring
Ensures continuity of care and improved accessibility, crucial for transplant patients who require long-term, specialized care.
Companies like BioIntelliSense specialize in wearable sensors that continuously monitor patient vitals, allowing healthcare providers to remotely track recovery progress while patients are at home. Additionally, CareDx's AlloSure provides non-invasive monitoring of transplant recipients' immune response, ensuring timely intervention and personalized care. These technologies are especially important for transplant patients who require long-term, specialized care.12
12. Chronic Care Management
Innovative solutions in chronic care management are enabling patients to receive transplants preemptively (before needing dialysis) as well as to adhere to post-transplant care plans, promoting long-term organ survival.
New payment models from CMS incentivize preemptive transplantation, leading many of the value-based kidney care players to leverage their population health and multidisciplinary care models to help nephrologists identify transplant candidates prior to patients progressing to kidney failure and requiring dialysis.1314
13. Immunosuppressant Drugs
Changes in policy and coverage for critical anti-rejection drugs are making transplantation a feasible option for more patients.
Companies like Astellas Pharma, Novartis, and Pfizer are actively involved in the development of immunosuppressant drugs that play a critical role in preventing organ rejection post-transplant. Policy changes and improvements in drug coverage have made these essential medications more accessible to transplant recipients, increasing the feasibility of transplantation as a treatment option.15
14. Implantable Sensors
Wearables and implantable devices that monitor vitals and organ health in real-time to optimize post-transplant care.
Several companies are at the forefront of developing implantable sensors that monitor organ health in real-time. These innovative technologies offer continuous insights into the well-being of transplanted organs, allowing healthcare professionals to make timely interventions and optimize post-transplant care. By providing crucial data and early detection of potential issues, these implantable sensors contribute to improved patient outcomes and extended graft survival, enhancing the overall success of organ transplantation.16
15. Gene Therapies
Though still in the early stages, gene therapies hold the promise of inducing immune tolerance to the transplanted organ, potentially eliminating the need for lifelong immunosuppressive medication.
Companies are exploring groundbreaking gene therapies that aim to induce immune tolerance to transplanted organs. While still in the early stages of development, these therapies hold the potential to revolutionize transplantation by reducing or even eliminating the need for lifelong immunosuppressive medications. By reprogramming the immune system to accept the transplanted organ as "self," gene therapies offer a glimpse into a future where patients can enjoy improved quality of life post-transplant without the burdens of chronic medication management.17
Parting thoughts
The people and companies working tirelessly to make transplantation more accessible and equitable are building a better future for all. Chances are, some of you who find this article are part of that group. If that's the case, thank you.
I'd love to learn more about the innovations you're following in this [space].
Hey, Tim here! The goal of my newsletter and podcast is to make the frontiers of healthcare technology more accessible and actionable for everyone. I write and interview experts about topics like learning, startups, commercialization, care delivery, and beyond. Join 4K+ fellow clinical, commercial, and technical business leaders as we explore a new [space] each month.
Paragonix Technologies Announces Milestone of 1,000 Preserved Donor Heart Transports (mHealth Times)
CareDx: A Robust Transplant Diagnostics Pick For 2020 (Seeking Alpha)
Breakthrough device that can keep donor livers functioning outside the body for 24 hours will revolutionise transplant surgery, experts say (Daily Mail)
Robotic-assisted Kidney Transplantation: Our Experience and Literature Review (Curr Transplant Rep, 2015)
Current state of navigation in spine surgery (Ann Transl Med, 2021)
Can VR training churn out better surgeons? (MedCity News)
Medtronic picks up BioIntelliSense's round-the-clock vital sign monitor in distribution deal (Fierce Biotech)
The Medicare CEC Model: Using Lessons Learned To Improve Value-Based Kidney Care (Health Affairs, 2022)
Wireless implantable optical probe for continuous monitoring of oxygen saturation in flaps and organ grafts (Nature, 2022)
Regulatory Cell Therapy in Organ Transplantation: Achievements and Open Questions (Frontiers, 2021)