I sent in to a meeting was rejected. When I spoke to the
program chairman, he said the abstract was rejected
because the science was not possible. I said, “What do
you mean? Those are our results!” He replied that they
didn’t believe that it could be done. The field was new,
so the concept of regenerative medicine was not well
received or understood. It was such a barrier to overcome, convincing others that it was actually possible.
You have been heavily involved in the ACS. What
drew you to this organization?
My early involvement was with the Surgical Forum,
which allowed me to attend the Clinical Congress and
participate as a presenter. Eventually, I was asked to
organize the Surgical Forum for urology. It has been
a wonderful experience to be involved with the ACS.
It has been very rewarding to interact with all the different specialties in surgery. It has allowed me to grow
personally as well as professionally.
You have had many important research discoveries.
What do you consider your greatest contribution?
That’s a tough question. I don’t really have a favorite
project because it is like asking who your favorite child
is. I have enjoyed each of the projects that I developed.
At the end of the day, what I find most stimulating is
the day-to-day work of moving a project forward. Major
discoveries do not happen in one day.
Moving something from the bench, through small
animal studies, and eventually seeing it come to
fruition in patients must be very rewarding.
Definitely. One of my biggest motivations has been
moving ideas from the bench to the bedside. That has
been the driving force of my career. It is a long pro-
cess, as you need to understand the cell biology, and
the science has to be solid and reproducible. How do
you take that science you have worked so hard on and
make sure that you can actually take it to the next step
and, finally, to the patient to see that it works? It is hard
enough to learn about the science that you are doing
and be certain that you are doing it correctly. Then you
have to understand the process of getting it through the
regulatory pathway, developing a product, and learning
how to succeed in the patient. You learn each of these
things along the way. It is not like you know how to
do it all on day one. It’s a multi-step process.
Has there been anything that you thought would
have a big impact but was a little disappointing
when you tried it clinically?
Thankfully, it has not yet happened because the
expectations were always centered on making sure
the technologies were safe. There have always been
some redeeming features of the cell-based therapies
or engineered tissues that have undergone clinic
trials, and we have learned [a great deal] from these
technologies. We learned early on that just because
something is a neat therapy and can be used clinically
does not imply that it can or should be implemented.
It has to be economically feasible for the patient and
health care system. The technology has to be transformational; it has to create a therapy that is not
possible via other means.
An example is engineered skin. You can create a
piece of engineered skin that is a partial cover and
acts as a temporary dressing. It might cost you $5,000.
Alternatively, you could use cadaver skin, which only
costs a few hundred dollars. At the end of the day,
they will both do the same thing, as they are both
acting as dressings. However, if you create a piece
of engineered skin that is going to be a permanent
replacement, and it is going to make the patient
better, and it’s not a temporary dressing, and it costs
$5,000, then it’s worth it because you have done
something that is transformational for the patient.