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It’s never been a more exciting time for medical breakthroughs, from understanding mysterious conditions like post-COVID-19 to using everything from stem cell therapies to smartphones to advance health and well-being. Many of these innovations are happening right here in the Pacific Northwest by UW Medicine researchers.
We rounded up five of the most mouth-dropping medical developments that happened at UW Medicine in 2023.
A dual heart-liver transplant
Last December, Adriana Rodriguez, a 31-year-old from Bellingham, experienced a spontaneous tear in one of her coronary arteries two weeks after giving birth. While such tears can sometimes heal on their own, Rodriguez’s heart was so damaged that it began to fail. She needed a transplant, but because of her recent pregnancy, her blood antibody levels were high, making it almost certain that her immune system would attack and reject a donor heart.
Dr. Shin Lin, a heart failure specialist, and Dr. Jay Pal, the heart transplant surgical director, made an unprecedented recommendation that she undergo a dual heart-liver transplant based on a few reports of immunological protection in patients who had been transplanted with a liver and then a heart to replace two failing organs. Because the patient’s own liver was normal, the plan was to domino it into another patient who had end-stage liver disease.
On January 14, during a 17-hour procedure at UW Medical Center – Montlake, Dr. Mark Sturdevant and Dr. Ramasamy Bakthavatsalam removed Rodriguez’s healthy liver, transplanted her with the donor organ, and transplanted her liver into another patient who needed one. Next, Pal and Dr. John Dimarakis transplanted the donor heart. After 65 days, her antibody response to her new heart disappeared, ending the immediate threat of organ rejection.
“We don't fully understand the science of transplant immunology,” says Dr. Daniel Fishbein, a colleague at the Heart Institute. “We need to understand the magic so we can hopefully, someday, repeat it with medications instead of an organ.”
A potential stem-cell treatment to regrow dental enamel
Researchers at the UW School of Medicine and UW School of Dentistry used stem cells to generate the proteins that create dental enamel, the stuff that protects teeth from getting damaged and prevents decay. They hope their findings could lead to a first-ever process to make new enamel for damaged teeth.
The body has no way to repair enamel: Specialized cells make the super hard tissue while teeth are growing, but those cells then die off when the teeth are fully formed. So a stem cell therapy to restore enamel while filling cavities, for example, would be a game-changer for repairing damaged teeth.
Hannele Ruohola-Baker, a professor of biochemistry and associate director of the UW Medicine Institute for Stem Cell and Regenerative Medicine, leads the lab that carried out this research in the Department of Biochemistry at the UW School of Medicine. She believes that one day, the findings could lead to “living fillings,” or fillings with stem cells that could reconstruct a broken or damaged tooth, or even a therapy that could grow a tooth back entirely.
“It may take a while before we can regenerate them, but we can now see the steps we need to get there,” Ruohola-Baker says.
A new way to screen for pre-diabetes using a smartphone
Researchers at UW Medicine and the University of Washington’s Paul G. Allen School of Computer Science & Engineering came up with a new, extremely accessible way to test for prediabetes: All you need is a smartphone and an inexpensive test strip. The system, called GlucoScreen, uses a drop of blood that reacts to enzymes on a strip, just like a traditional prediabetes screening. But instead of needing to come into a doctor’s office or to purchase a commercial glucometer, the test strip can be read by a smartphone’s touch screen.
“We took the same test strip and added inexpensive circuitry that communicates data generated by that reaction to any smartphone through simulated tapping on the screen,” says Anandghan Waghmare, a PhD student in the Allen School’s UbiComp Lab, who was part of the research team. “GlucoScreen then processes the data and displays the result right on the phone, alerting the person if they are at risk so they know to follow up with their physician.”
This is a big deal because 80% of people with prediabetes don’t know they have it, often because of lack of access to screening for it. If prediabetes is detected early, it can be reversed by diet, exercise and other lifestyle changes before becoming type 2 diabetes. GlucoScreen could lead to much higher rates of early detection given how easy and affordable it is to use.
"One of the barriers I see in my clinical practice is that many patients can't afford to test themselves, as glucometers and their test strips are too expensive," says co-author Dr. Matthew Thompson, a professor of family medicine at the UW School of Medicine. "Given how many of my patients use smartphones now, a system like GlucoScreen could really transform our ability to screen and monitor people with prediabetes and even diabetes."
A discovery that could explain post-COVID-19 brain fog
A team of researchers at the UW School of Medicine, as well as the Veterans Affairs Puget Sound Health Care System and Oregon Health & Science University, conducted an experiment that led to a new understanding of how a respiratory illness like COVID-19 can cause cognitive impairments such as brain fog and memory loss. They found that the spike protein attached to most variants of the SARS-CoV-2 virus was easily able to pass from a mouse’s bloodstream into its brain. Once there, it caused inflammation, which can lead to the cognitive issues associated with post-COVID-19.
The good news is that targeted antibodies were shown to block the S1 protein from entering the brain — just another reason to stay up to date on COVID-19 vaccinations and boosters.
A pacemaker that could someday recharge its battery with heartbeat energy
A futuristic-sounding pacemaker prototype, developed by mechanical and biomedical engineers working with Dr. Babak Nazer at UW Medicine, showed that it's possible to convert mechanical energy created by a heartbeat into electrical energy that could recharge a pacemaker.
A traditional “transvenous” pacemaker is powered by a pulse generator placed under the skin below the patient’s left collarbone. Wires (“leads”) connect to the generator and are threaded from the device, through the veins and into the heart to correct rhythm disorders.
New “leadless” pacemakers are less than half the size of an AAA battery, small enough to be implanted entirely in the heart itself, meaning no wires are needed. But there’s a big drawback: There is no way to replace the battery, which typically lasts five to twelve years. For younger patients who might need a pacemaker for decades, this poses a problem. It can be difficult to retrieve an old pacemaker and the heart chamber has limited room for replacements.
The prototype developed in Nazer’s lab would address this issue by extending the battery life of the wireless pacemakers. That goal is still a ways off — the first device only generated about 10% of the energy needed to stimulate a heartbeat, and they have yet to try it on a human heart. But, says Nazer, “There’s merit to developing technology that prolongs battery life to reduce the medical burden of multiple implants and retrievals, and start expanding access of leadless devices to younger patients.”
