A Culture of Innovation: Multidisciplinary Team wins Shark Tank Competition - Research Category

The health care field is ever evolving – and leaders at the Medical University of South Carolina want faculty, staff and students to be at the forefront of change. The annual Innovation Week event showcases innovation occurring across the enterprise and encourages everyone to see themselves as innovators, too. The highlight of the week is the live Shark Tank funding pitch. Nine teams out of 100 got the chance to describe their ideas to a team of "sharks,” and three teams won funding to pursue their projects.

The MUSC Department of Surgery was well – represented. In fact, faculty and staff were either lead authors or participants in15% of the poster presentations across the three categories: Research, Care, and Education, with one team advancing and winning the Shark Tank Research Category.

Partial Heart Transplantation: a New Operation for Children Requiring Valve Replacement is the research led by pediatric cardiac surgeon T. Konrad Rajab, M.D., M.Chir., that is a promising new approach for babies born with heart valve defects. The multidisciplinary team that won the Shark Tank research category includes: Satish Nadig, M.D., Ph.D., P.K. Baliga Endowed Chair in Solid Organ Transplantation and associate vice chair of research in the Department of Surgery, John Costello, M.D., the vice chair of clinical research in the Department of Pediatrics and director of research for the Children’s Heart Center, Steven Kubalak, Ph.D. professor in the Department of Regenerative Medicine and Cell Biology and director of the MUSC Anatomical Gift Program, cardiothoracic surgery resident Jennie Kwon, M.D. and medical student Morgan Hill.

Seven in 1,000 newborns have congenital heart defects, which often involve the heart valve. Unfortunately, unlike for adult patients, there are no good options for doctors and patients to replace the heart valves of a newborn. Doctors can implant mechanical valves in older babies and children, but these valves do not grow with the child. Instead, as the child grows, new valves must be implanted, meaning a child could undergo five or more open heart surgeries, said medical student Morgan Hill.

There are no mechanical valves on the market that are small enough for a newborn. There are a few procedures that doctors can perform on small babies, but none have emerged as a gold standard. Neonatal heart transplant, on the other hand, has the best outcomes of any solid organ transplant.

With this in mind, the MUSC team proposed a transplant variation aimed at children with valve defects. By transplanting only a valve, not the entire heart, not only would the valve grow with the child, but the medical team could implant a mechanical valve once the patient was full-grown, allowing the patient to stop taking immunosuppressant drugs.

Hill explained that up to a third of potential infant donor hearts aren’t used because of poor functioning, but those deficits rarely affect the valve.

“We expect partial heart transplantation to have an immediate impact in the clinic,” Hill said.

Kwon said the team has done preliminary work on developing the proper technique but will refine the surgery further. Although similar to existing surgeries, there are technical challenges that must be addressed, she said. For instance, mechanical valves are manufactured with features to simplify implantation. Donor valves, on the other hand, don’t have these features. She is also working in the Transplant Immunobiology Laboratory under the mentorship of Nadig to clarify the immunobiology of this new type of transplant. 

Rajab expects the process to take several months before the team is ready to publish an article describing its surgical techniques. The team is also designing a pilot clinical trial, which will be led by Rajab and Costello.