Hundreds Meet in Osaka to Discuss Artificial Organs
Cutting Edge of Medical Research
The field of artificial organs covers a broad range of disciplines dealing with the body organs that enable human life, from those of young infants to the elderly. Artificially created organs are now available to serve the roles played by the heart and liver, as well as the lungs, kidneys, bones, arteries and veins, and even the pancreas. Given the difficulty of finding proper donors, there are now moves to develop artificial hearts that can be permanently implanted in the patient's body as well as organs that utilize the body's natural cells and tissues. The development and clinical application of artificial organs are at the forefront of medical research -- along with organ transplantation and genetic treatment -- and may be considered the ultimate form of medical cure. They are also seen as having the potential to make a great contribution to the maintenance of human health. It is within this social context that the 13th World Congress of International Society for Artificial Organs is being held in Osaka to hear the latest discoveries and exciting breakthroughs in cell and tissue engineering, regenerative medicine, transplantation, and many other areas.
The 13th World Congress of International Society for Artificial Organs was opened on November 5, 2001 at Osaka International Convention Center jointly with the 39th Annual Meeting of Japanese Society for Artificial Organs. It was attended by around 400 doctors and medical researchers from around 20 countries and regions, including Japan.  The purpose of this Congress is to facilitate discussions on the research, development and clinical application of artificial organs as replacements of end-stage organ failures. From the perspective of artificial organs as an alternative treatment, topics for discussion will not be limited to artificial organs but will include the latest advancements that have been made in tissue engineering, regenerative medicine, cell transplant and other areas as it is hoped that such discussions will assist front-line doctors and researchers to establish a still more advanced alternative treatment for patients.
 At the opening ceremony, which began from 5:30 p.m., Dr. Shin'ichi Nitta, President of the International Society for Artificial Organs (ISAO) cordially welcomed all the participants, most especially those who had traveled a long distance despite the difficulties in air travel at this time. He stated that he was honored to hold the Congress in Osaka, as this would make it the fourth time for it to be held in Japan since the first in 1977 in Tokyo.
He was followed by Dr. Tadamitsu Kishimoto, President of Osaka University, who stressed his pleasure in having a world-class conference of such importance being held in Osaka, urging the participants to take the fullest advantage of their scientific and social stay in this city during the beautiful season of autumn.
Dr. Hikaru Matsuda, Congress President of the 13th World Congress of International Society for Artificial Organs was next, who stated that it was a most memorable Congress as it marked the beginning of a new century and that current trends in artificial organs were expanding with many innovations taking place which have made for smaller, less bulky devices.
The words of welcome were followed by the awarding of the Osborne Award. According to Dr.  Peter Ivanovich, First President of the Executive Committee of ISAO, who gave an abbreviated history of the award and introduced the presenter, Burl Osborne, Chairman-Elect of the Associated Press and recipient of many Pulitzer Prizes, the ISAO decided to present the award to lay people who had contributed to the advancement of organ and artificial organ transplantation. Known as the Organ Replacement Pioneer Hero Award, Osborne was the first recipient of this award. Later, it was renamed in honor of Osborne who had since his first kidney transplant, supported the ISAO and helped to spread better understanding of this new advancement in medicine. Prior to presenting the award, Osborne expressed his sincere appreciation of all the medical experts and people concerned in the field of organ transplantation and artificial organs, stating that they were worthy of admiration and respect for making the replacements of organs practical, calling them heroes who had enriched the lives of hundreds and thousands of people. He introduced this year's recipient, Motohiko Ozaki, as the first pioneer in Japan to be placed on an external circulatory device, which had enabled him to fly to Texas for his transplantation surgery as in 1992, such operations were still illegal in Japan. Motohiko Ozaki thanked the doctors who had given him a new lease on life and stated that he was indeed honored to the recipient of such a prestigious award.
The Opening Ceremony was followed by two Special Lectures: One was by Dr. John Watson, Acting Deputy Director, National Heart, Lung, and Blood Institute of the National Institutes of Health, U.S.A. who spoke on bioengineering circulatory support device, while the second was by Dr. Robert Bartlett, Director of the Extracorporeal Life Support Program at the University of Michigan, U.S.A. who spoke on the Extracorporeal Life Support Program.
Following the completion of all the special events of the day, the participants attended the Welcome Reception held at the Rihga Royal Hotel to renew old acquaintances, and to forge new ties.
The Congress will continue until the 8th and promises to be an exciting and information-filled one with Early Bird, Plenary, Slide and Poster Sessions as well as Panel Discussions slated.
Fourth Congress in Japan
By Dr. Shin'ichi Nitta, President, International Society for Artificial Organs
On behalf of ISAO, I am delighted to welcome you all to this meeting and also deeply appreciate your coming, particularly those who have come from a long distance to be here under such  unexpected difficulties in regard to flying and so on. This is actually the fourth time to hold this important Congress in Japan. The first one was in 1977 in Tokyo by Professor Inoh, the second one was in 1983 in Kyoto by Dr. Tatsumi and the third one was in Sapporo, Hokkaido, in 1989 and this time in Osaka by Professor Matsuda. As the president of ISAO, I would like to thank Professor Matsuda, Congress President of the ISAO and his colleagues, and also all the committees concerned for providing such a splendid arrangement for the meeting. Please enjoy the meeting and I wish you a pleasant stay in Osaka, Japan and hope that you will take back with you fruitful, fine, and happy memories. Thank you very much.
A Core Conference in an Evolving Field
By Dr. Tadamitsu Kishimoto, President, Osaka University
Distinguished Guests and Ladies and Gentlemen. It is my great honor and privilege to welcome you to the World Congress of International Society for  Artificial Organs. As President of Osaka University, I am very much pleased to have this world leading conference here in Osaka, organized by Professor Matsuda, professor of surgery at Osaka University School of Medicine.
I understand this society has a long history and reputation in the field of medical science technologies, developing important medical diagnostic therapeutic modalities and saving the sick patients with various end-stage organ failures. Currently the scope of artificial organs has been greatly expanded from the conventional to the new world progressing with advanced technologies and medical care. I have heard the topics at this conference cover molecular biology and genetic cell and tissue engineering to mechanical artificial devices. I believe that this Congress will have an important role as a core conference in this evolving field.
And now, autumn is the most beautiful season in Japan. I therefore hope you enjoy your scientific and social stay in Osaka to the fullest. Thank you very much.
New Era in Artificial Organs
By Dr. Hikaru Matsuda, Congress President, The 13th World Congress of International Society for Artificial Organs
I would like to welcome all of you to this ISAO World Conference here in Osaka. As everybody knows, we had a very sad and painful time after the  terrorist attacks on September 11th. We pray and give our sincere sympathy to all the victims, families and people of the United States who were directly or indirectly affected. Despite this tragedy, we, as local organizing committee members are very appreciative of all who have supported this Congress so it could be held and thank the many members and guests coming from abroad. In the field of artificial organs, we have been working for those who suffer from end-stage organ failure. There are now many innovations. Artificial organs are not limited to large and bulky mechanical devices in basic treatment and extend to the patients supported by various basic sciences such as genomic analysis, molecular biology and tissue engineering. In this Congress, we have 247 abstracts and a total of seven plenary and eight panel discussions and eight early bird sessions. We are sure that this meeting will contribute to the progress of artificial organ technology and medical care.
Progress Toward Total Artificial Hearts
Implantable, self-contained mechanical circulatory support (MCS) devices have demonstrated functional effectiveness as a bridge to transplantation for patients with advanced heart failure, noted John Watson, Ph.D., of the National Institutes of Health's National Heart, Lung, and Blood Institute.
 Dr. Watson gave the first Special Lecture during the Opening Ceremony of the 13th World Congress of International Society for Artificial Organs, which opened on November 5 in Osaka, Japan.
He charted the history of vascular assist devices as well as self-contained total artificial hearts, focused on recent clinical evidence and current research activities, and highlighted emerging areas and various exciting future frontiers, noting that what we will be calling artificial organs 20, 30 years from now would be quite different from those in use today.
Heart failure affects nearly 5.0 million people in the United States, with an estimated 550,000 new patients every year.
While the number has been on a downward trend since the 1960s, it is still the largest killer in the united States and affects men, women, and all races equally.
Heart failure accounts for 43,000 deaths each year and contributes to another 220,000 deaths.
Each year only about 2,300 patients receive a cardiac transplant, with 20% of the approximately 4,000 patients on waiting lists dying before a donor organ can be found.
The vision and research focus of the National Heart, Lung, and Blood Institute's MCS Program has, therefore, been on long-term implantable circulation support systems, which could benefit a significant portion of the heart-failure population.
That vision was first formulated by Dr. Frank Hastings, who was director of NIH's Artificial Heart Research until he passed away in 1971 and to whom Watson dedicated his lecture.
Not only do MCS patients report a reasonable quality of life but also sometimes see spontaneous recovery of their cardiac and other functions, such as those of the kidneys, and eventual device removal.
The vision for first generation of VADs was a design that was highly reliable for two years, that provided a good quality of life, and that was affordable for society.
Because these devices entailed a break in the skin, however, they were associated with a higher risk of infection.
Thus effort was made to develop self-containing systems to reduce the infection rate.
The first generation total artificial heart was envisioned as a bridge to recovery with a reliability of five years, just as with the second generation of VADs.
Watson also outlined clinical evidence and surveyed the efforts now being made to develop self-contained VADs Emerging areas of research, including the third generation of VADs, are now pursued under a new NIH research infrastructure, in particular, by the newly created National Institute of Biomedical Imaging and Bioengineering, whose mission is to improve health by promoting fundamental discoveries, design and development, and translation and assessment of technological capabilities.
Another new venture is the Bioengineering Consortium (BECON) that opens up trans-NIH opportunities, such as through organizations of symposiums.
In the field of reparative medicine, moreover, he cited nanoscience as offering many exciting opportunities for biological applications. One to 100 nanometer range assemblies with extraordinary properties can be developed that could effectively narrow the gap between the synthetic and natural worlds, Watson noted.
Nanometers may be assembled that would fulfill total VAD functions, leading to whole organ replacement.
Watson concluded his remarks with the hope that more energies would be put into making valuable discoveries that enrich human lives, instead of worrying about destructive terrorist acts.
Effectiveness of Extracorporeal Life Support
In the second Special Lecture of the Opening Ceremony of the 13th World Congress of International Society for Artificial Organs, Dr. Robert Bartlett of the University of Michigan, Ann Arbor, spoke on the effectiveness of extracorporeal life support systems for patients suffering from respiratory failure.
Bartlett, M.D., is the Director of the Extracorporeal Life Support Program at the University of Michigan and Professor of General and Thoracic Surgery and Division Chief of the university's Surgical Critical Care.
 Citing clinical evidence, both those he has personally overseen and those undertaken by researchers around the globe, he explained the various types of ECLS during cardiopulmonary bypass surgery, noting the importance of applying the proper mode depending on the type of operation performed.
ECLS has been shown to be particularly important in the treatment of newborn infants suffering from respiratory failure. The first successful application of this technology was in 1971. Thanks to this technology, a three-month-old orphan has now grown to be a healthy and vibrant woman, demonstrating the value of medical technology in the enrichment of human life.
Of the 23,556 patients who have been under extracorporeal life support, the total survival rate has been 68%, the most successful being newborn infants with respiratory or cardiac failure. While admitting that the survival rate is not perfect, he noted that it is still better than seeing newborn infants die. Bartlett designed the technology as a cardiac and respiratory support system for young children as a bridge to the implantation of vascular assist devices that Dr. Watson mentioned in his lecture, which in turn, are bridges to organ transplantation.
The first adult case was in 1971 in California, performed on a patient suffering from adult respiratory distress syndrome (ARDS). It was found that with proper patient management, including dieresis to remove fluid and by turning the patient prone to mitigate the consolidation of fluid in the posterior lungs, in most cases improvements could be observed.
When this failed to produce the desired results, the patient then became a candidate for extracorporeal life support, as they would otherwise die of acute for respiratory failure.
Cardiac support has also proven vital where no mechanical devices are available, mostly for children following cardiac surgery.
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