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Prof. Maciej Kosieradzki about Polish researches in the field of transplantology:

‘We can see vast opportunities opening ahead of us.’

Research work on the innovative Polish NanOX organ storage system is entering increasingly advanced stages. In an interview with Prof. Maciej Kosieradzki, head of the Department of General and Transplant Surgery at the Faculty of Medicine of Medical University of Warsaw, we asked him how the introduction of a new standard for organ storage could change the face of transplantation.

You are currently researching an innovative liquid for storing organs for transplantation. Can you tell what this innovation consists of?

Perhaps let’s start with why organ storage is needed at all. The moment a person dies somewhere in Poland, let’s say in Suwałki, and we drive from Warsaw to Suwałki to retrieve the organ and bring it to Warsaw. From a list of about 1,200 people waiting for a kidney transplant, we select the 2 most genetically similar to the donor. They must not have blood serum antibodies against the donor. In order to test this, we treat live donor lymphocytes with the serum of our selected recipients, and only after observation do we know that we can effectively and safely transplant organs. In case of the kidney, this process takes about nine hours. Only then do we know that we have patients selected for transplantation. Next, they head to the dialysis station and have to reach us for surgery. Throughout this time, we must keep the organ alive. Normally, after the cessation of circulation, the process of tissue death begins. So far, we have only been able to slow down the process by cooling down, slowing down the metabolism and using preservative fluids. This gave us six hours in the case of the heart, 12-16 hours in the case of the liver and 24 or even 36 hours using a perfusion pump, in the case of kidney transplantation, to make the necessary arrangements to transplant the harvested organ to the recipient.

And there is a place for the liquid you are working on as a part of NanoGroup’s research?

Our idea is to store organs in normal temperature conditions. Attempts have been made to make this a reality for many years – such solutions are being used in the storage of the heart, lungs or liver. Thanks to that, organs can be stored for a relatively long time. We made the assumption that if we could get as close as possible to the 37°C temperature at which our enzyme system functions, such an organ would stop dying. That’s the idea behind the NanOX fluid being developed by NanoGroup with an oxygen carrier and the use of normothermia.

I’d like to speculate that if we reperfuse already partially damaged organs with blood, the cell death process accelerates rapidly due to contact with blood and its leukocytes. I suppose that if we would restore circulation and normal metabolism without perfusion fluid devoid of leukocytes and platelets, we may be able to still save a large part of these cells, dying by apoptosis mechanism, and if that is not possible, allow the removal of toxins and residues formed after cell death due to necrosis.

This would mean that the risk of rejecting such an organ decreases?

Yes, and on top of that: it will improve this organ’s condition. It will then be in better condition, better regenerated, its efficiency should be much higher from the beginning. But that’s not all. For years, various attempts have been made to, let’s say: treat organs while they are in storage. Human enzyme systems are adapted to respond to stimuli or drugs at 37°C, for example. If we would be able to keep this organ normothermic, we could potentially still do a lot with it in the distant future.

First, we gain time – we can store this organ for numerous days without losing its quality. Secondly, we can even try to improve its quality by introducing genes to prevent cell apoptosis or to hide or modify the immunogenicity of the organ before it comes into contact with the recipient’s organism and, through this gene insertion, make the organ specific to the recipient – such a custom-made solution.

Finally, most organs are transplanted from deceased donors, who are mostly ill from various causes and as a result may have damaged kidneys, livers or hearts. With this solution, we may be able to successfully treat some of these diseases or remove their effects in an isolated organ. A very wide range of possibilities are indeed opening up. Today, I can’t even quite imagine what my fellow scientists could do with such a preservative fluid, devoid of blood and allowing very long organ storage”.

At what stage is the development of this technology currently underway?

We are working on isolated organs at the moment. We can see that they are functioning. We deal with kidneys harvested from animals, which are deliberately severely damaged by us. We subject them to warm ischemia, a situation in which the circulation stops, and after half an hour only remove such an organ, then keep it still in hypothermia for a long time to aggravate the damage, and only then start resuscitating it, subjecting it to perfusion in NanOX fluid. The condition of these organs really improves a lot, they regain their optimal condition. At some point, they start secreting urine-like fluid, meaning the kidney performs physiological processes – you can see that it undergoes repair. Today, NanoGroup is at this isolated organ perfusion stage, whose viability we study somewhat indirectly, based on the characteristics we know a living kidney should have.

And what are the further plans for research work?

We are approaching the point where such a badly damaged kidney, repaired with NanOX storage liquid, will be transplanted back into the animal and we will look at whether it is sufficient for the animal to survive. This will confirm the effectiveness of the method. Next, there will still be the question of how many animal experiments need to be performed to register the fluid and technology for use in humans. It is unlikely to be many years, but there’s definitely a lot more experimentation to be done.

Have there been any unexpected situations or complications during the research so far? Or has there been some surprising observation that you did not expect?

The abundant urine output, the fact that this kidney so powerfully damaged took up function quite quickly was probably the most surprising sight. This is very good news. We didn’t expect it. In kidneys stored in hypothermia, using today’s fluids in humans, we don’t get to see such a turnaround very often.

Of course we had a lot of challenges along the way, problems to solve – such as the fluid modifications we had to decide on during the experiment. It is also difficult to predict what the body’s reaction will be to such an organ after implantation and trace residues of preservative fluid. Interesting scientific observations probably await us at this stage. However, I am positive and look forward to the next research stages.

Copyright © NanoGroup 2024

Paweł Ciach

Member of the Supervisory Board of NANOGROUP S.A.

Diplomat and specialist in the marketing and media industry. Graduate of the Department of International Relations at the National Institute of Oriental Languages and Civilizations in Paris and history and sociology at the Higher School of Social Sciences at the Faculty of History in Paris. Graduate of the Diplomatic Academy (Diplomatische Akademie) in Vienna and Postgraduate Management Studies at the Faculty of Management at the University of Warsaw. Worked as a journalist, publicist, reviewer, translator and foreign correspondent. Former advisor to the president of the board for media relations at the Agricultural Market Agency and president of the board of Press-Net. Public Relations trainer, among others at: Migut Media, Knowledge, ECU International, Advertising Academy Adam Śledański. He served as director of the board office of the Association of Organizations for the Employment of Disabled Persons and president of the board of the foundation “Niezależny. Fundacja na rzecz Nieprawni”. Lecturer at the Institute of Journalism of the Warsaw School of Advertising.

Jose Arrieta

Member of the Supervisory Board of NANOGROUP S.A.

Jose Arrieta is the former Chief Information Officer and Chief Data Officer of the United States Department of Health and Human Services. He oversaw $6.3B in IT investments, $800B in grants and $26B in Federal contracts in his last three years at HHS. He provided cyber security solutions for 174,000 people and a network that transacted with over 160 countries around the world. Jose led the creation and implementation of the largest public health surveillance capability in the United States during the pandemic and led the implementation of a national supervised machine learning effort to accurately distribute testing supplies and predict pandemic “hot spots” across the United States. He successfully defended the HHS network against multiple large scale nation state driven cyber-attacks. He led the first three implementations of blockchain technology in the public sector in the United States one of which was focused on reducing costs and speeding up procurement lifecycle. Jose was a cabinet level agency executive in the following positions: deputy assistant secretary for acquisition and grants, chief information officer, chief data officer, small business executive chief acquisition executive and senior procurement executive. Jose managed the largest contracting vehicle in the United States. He created and taught the first blockchain course (blockchain and cryptos) at Johns Hopkins University and taught business courses at University of Virginia and Prince George’s Community College. He founded small incubator called imagineeer when he left Government and works with customers and advises start-ups in the following markets: healthcare, food, energy, climate change, streaming and analytics, cybersecurity, artificial intelligence, and quantum computing. He is a member of the Navy Secretary’s Science and Technology Advisory Board.

Marek Borzestowski

Member of the Supervisory Board of NANOGROUP S.A.

For many years, President of the Management Board of NanoGroup, a holding company of biotechnology companies. Entrepreneur, manager and founder of many innovative companies with over 20 years of experience as co-owner and board member in leading Polish biotechnology, IT and e-commerce companies. After over a decade of work as president of the first internet portal in Poland – Wirtualna Polska, he founded the Polish-Israeli VC Giza Polish Ventures. Founder of the Sobieski Institute think tank, Startup Hub Poland Foundation. Member of supervisory boards in many innovative companies. Marek is a graduate of the Faculty of Management and Economics of the Gdańsk University of Technology, he also studied at the University of Wales in Great Britain. He conducted scientific research at the Center for Nuclear Research in Karlsruhe and the Gdańsk University of Technology.

Artur Olender

Member of the Supervisory Board of NANOGROUP S.A.

Investor, entrepreneur and financial advisor with over 28 years of professional experience. He managed the oldest Polish brokerage company – DM Penetrator S.A. Partner in Addventure and chairman of the supervisory boards of Intersport Polska S.A., Ailleron S.A., Archicom S.A., Sotis Sp. z o.o., OTC S.A. Former advisor to the Minister of Ownership Transformations and the Minister of the Treasury in privatization processes. Active participant in many environmental and legislative initiatives for the development of the Polish capital market. He participated in the implementation of dozens of projects to raise capital on the private and stock exchange market. He introduced to the stock exchange, among others, Mostostal Warszawa, Odlewnie Polskie, Poligrafia, WSiP, Polmos Białystok, Intersport, K2, Inteliwise, Cyfrowy Polsat, OT Logistic, Mercator Medical, Ailleron and Archicom. He studied at AGH and London Business School. Privately: windsurfer, sailor, skier, traveler, poet, composer and philanthropist.

Tadeusz Wesołowski

Member of the Supervisory Board of NANOGROUP S.A.

A well-known investor focused on companies from the medical and biotechnology industries. He has extensive professional experience in the healthcare sector. Founder of Prosper S.A., which is part of the NEUCA S.A. Capital Group – the leader of the pharmaceutical distribution market in Poland. Member of the supervisory boards of companies listed on the Warsaw Stock Exchange: NEUCA, Selvita and Braster. He is also involved in Venture Capital funds: Inovo and Experior. Doctor of Technical Sciences, graduate of the Warsaw University of Technology.

Robert Dziubłowski

Member of the Supervisory Board of NANOGROUP S.A.

Co-founder of Top Consulting S.A., one of the oldest consulting companies on the Polish market. He has over 25 years of international experience in the field of investment consulting, capital raising for companies, market acquisitions and company management. Long-time consultant to American financial organizations on Wall Street in New York, including those listed on the NASDAQ and NYSE stock exchanges. He advised, among others: Household International in preparing an acquisition strategy and obtaining a banking license in Poland, Wussler Group, a partner of Ted Turner Pictures in its attempt to take over NTV, the largest private television station in Russia, Eiffage Construction in the takeover of Mitex, the largest construction company at that time, Industrial Union of Donbas, an industrial group in Ukraine. Member, chairman and president of supervisory boards of many companies listed on the Warsaw Stock Exchange, including: Bauma S.A. (currently ULMA S.A.), Computerland Poland S.A. (currently Signity), PolAqua S.A. Co-founder of the Start-up Hub Poland Fund. Graduate of the Faculty of Journalism and Political Science at the University of Warsaw and International Relations at the University of Hawaii in Honolulu.

Jerzy Garlicki

President of the Supervisory Board of NANOGROUP S.A.

Medical doctor, also completed MBA, effective manager. Organizer of business model and company structures – experienced in building and developing companies and conducting restructuring processes of enterprises. In the past director and motivator of large companies and teams of people. A man recognizable as a leader in the Polish pharmaceutical industry. Member of the Supervisory Board of American Heart of Poland SA and President of WSiP SA. Previously President of Astra Zeneca Sp. z o.o., President of Fournier Polska Sp. z o.o., Sales Director of Pfizer Polska Sp. z o.o., Sales Director and Marketing Director of MSD Poland – also operating in the area of clinical trials.

Prof. Tomasz Ciach

Founder, Member of the Management Board of NANOGROUP S.A.

Nanotechnology expert. Professor at the Faculty of Chemical and Processing Engineering, Warsaw University of Technology, head of the Biotechnology and Bioprocessing Division. Author of two technologies that are already in production stage, 12 granted patents and over 50 publications. Founder of BioMedLab research group, consultant in numerous companies (AstraZeneca, Procter and Gamble, Reckit, Adamed, Balton, Galmed). Work on various aspects of Biomedical Engineering, mostly on biomedical nanotechnology, active coatings for medical implants, nanoparticles for cancer treatment, biodegradable and nonbiodegradable implants, bone and vascular prosthesis. He gives rare, but already brilliant example of how brave ideas become socially and financially valuable.

Piotr Mierzejewski

Vice President of the Management Board of NANOGROUP S.A.

Clinical pharmacology specialist, former advisor to the Minister of Health on drug policy. He negotiated Poland’s accession to the EU in the field of pharmacy, responsible for the implementation of EU directives in the field of pharmacy into the Polish legal system. Co-founder of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products. Owner of a consulting company cooperating with international pharmaceutical companies in the field of introducing new technologies to the Polish market.

Przemysław Mazurek

President of the Management Board of NANOGROUP S.A.

Associated with the health market since 2004. As Managing Director, he restructured and developed the most dynamically operating Medical Center in the Podkarpacie region, creating and setting new standards of customer service quality on the market. Co-creator of the first solution in Poland for online registration of medical appointments. Co-founder of the first and only Infertility Treatment Clinic (MEDICOR) in Podkarpacie, which he headed as the President until 2009. He was responsible for the development of health insurance in the PZU Group. As Vice President of PZU Pomoc S.A. created the largest medical TPA in Poland to handle health insurance. Co-founder of the first drug insurance in Poland. Since 2015, he has been active in the field of Wealth Management and advises on management and finance. A graduate of International Economic and Political Relations as well as Management and Marketing at the Warsaw School of Economics.

Przemysław Mazurek

President of the Management Board of NANOGROUP S.A.

Associated with the health market since 2004. As Managing Director, he restructured and developed the most dynamically operating Medical Center in the Podkarpacie region, creating and setting new standards of customer service quality on the market. Co-creator of the first solution in Poland for online registration of medical appointments. Co-founder of the first and only Infertility Treatment Clinic (MEDICOR) in Podkarpacie, which he headed as the President until 2009. He was responsible for the development of health insurance in the PZU Group. As Vice President of PZU Pomoc S.A. created the largest medical TPA in Poland to handle health insurance. Co-founder of the first drug insurance in Poland. Since 2015, he has been active in the field of Wealth Management and advises on management and finance. A graduate of International Economic and Political Relations as well as Management and Marketing at the Warsaw School of Economics.