▲ KOAC Team. Provided by the KAOC.

“KAOC is the first and only artificial organ research center in Korea,” says Professor Sun Kyung (Medicine), the director of the Korea Artificial Organ Center (KAOC). While most of Korea University (KU) students are not well aware of the existence of this research institute, KAOC is widely known in the global medical community for its groundbreaking research and results in the field of medicine.

Foundation, Dedication and Accomplishment

“My spirit in founding KAOC was to fulfill my dream of prolonging life expectancy and the responsibility given to me as a medical professional,” says Professor Sun. “In order to do that, society needed more than what we had.” With this sense of firm dedication, Professor Sun established KAOC on the Green Campus of his alma mater, KU.

Originally, when a patient’s organ failed, all that a doctor could do is put the patient on a transplant list and keep the patient alive until a suitable donor organs arrived. However, the number of organs needed far outnumbers donated organs. This is a global phenomenon, and Korea is no exception. In fact, because of some cultural elements, mostly based on Confucianism, the situation is worse in Korea than in many countries. Therefore, two new approaches have been invented, and the most impressive characteristic of KAOC is that it has significant result in both.

The first approach is to put the patient on a life-sustaining support system in order to buy the patient enough time while waiting for the suitable organ. Life support technology has been used and improved upon for the last 50 years, which KAOC has contributed to as well. On 28 October 2004, KU Ansan Hospital cardiothoracic surgeon Shin Jae Kyung saved two patients’ lives using a KAOC designed Pulsatile Life Support System (T-PLS).

The second approach is use artificial organs to extend patients’ lives. In terms of heart failure, the Implantable Biventricular Assist Device or AnyHeart is an excellent representative example of KAOC’s achievement. Normally, there are two ventricles in the heart that pump blood throughout the body. While there have been more than 2,000 successful implantations of assistance devices that can do the task of one of the ventricles, the replacement of the total functionality of both ventricles, thus replacing 100 percent of the heart’s cardiac output with a machine was first accomplished by KAOC’s AnyHeart.

AnyHeart was first implanted in a patient on 12 April 2001. Unfortunately however, the patient, whose surname was Hong, died after 12 days. Although many people might consider the implantation process of AnyHeart involves the secession of the native heart, that is not true. The AnyHeart has four pipes that connect to the native heart and do the task of pumping blood for it. One advantage of this approach of is that the native heart can take over in case the AnyHeart is broken, until it is fixed.

The most crucial advantage of this approach is that the native heart could possibly recover to some extent in response to new treatment modalities. “Replacing the native heart completely with mechanical ones is not a bad idea,” says Professor Sun, “but healing the native heart is an even better medical treatment plan.” In other words, while other types of artificial hearts could gravely impede the recovery of the native heart, AnyHeart keeps that potential alive, and even if it never becomes real, AnyHeart can still function as a replacement.

One of the most fundamental reasons of KAOC’s success is that its researches are not limited to the boundary of medicine but also actively take advantage of other relevant fields, such as mechanical, electrical engineering and biology. The philosophy behind this structure is very simple. If the KAOC had developed researches in the medical field, it would have been very difficult to yield outstanding outcome because there are tens of thousands of facilities doing that, generating very limited results. Therefore, realizing the power of convergence, Professor Sun recruited PhDs of engineering and biology majors, and created some of the most extraordinary equipments that set an unprecedented example in the field of artificial organs.

Behind the Glory

As an old maxim "No pain, no gain" asserts, the success of KAOC could not have been attained without hard work behind the scenes. With his resolute dedication, Professor Sun and KU have made tremendous efforts in researching new artificial organs. However, Professor Sun and KAOC did not meet the biggest obstacle until they achieved some of their greatest accomplishments, including AnyHeart.

Before Professor Sun announced his success in completely replacing the functionality of a patient’s heart function with an artificial organ for the first time ever, most of the groundbreaking medical accomplishments in Korea had been attributed to professors and researchers at Seoul National University (SNU). Therefore, many doctors and researchers who graduated from or were working in SNU tried to diminish the accomplishment of Professor Sun. Professor Sun and KU thus faced a lot of unfair criticism from the medical community.

The glory of Professor Sun did not last long. After Hong died, Professor Sun and KU were condemned for “recklessly executing the implantation without the approval of the Korea Food and Drug Administration and risking the life of the patient for personal ambition and the glory of the hospital.” In fact, the implantation was not a clinical trial, but more of a “rescue” surgery at the request of the patient’s family.

Devastated by the criticism, Professor Sun considered abandoning the entire project more than once. Nonetheless, many delightful events took place. A University of Toronto professor, a leader of myocardium cell transplants, contacted Professor Sun to develop cell transplantation and AnyHeart as one project and research it together. Most importantly, the Society of Cardiovascular Anesthesiologists published a research paper about the AnyHeart that recognized its functionality. This paper left those criticizing Professor Sun no choice but to recognize him as a leading pioneer in this field.

The Next Step

“Whatever is invented, it is useless without mass application for those who need them,” remarks Professor Sun. After a prototype is invented, it has to be produced in a large enough number in order to make it financially feasible. In medicine, this is more difficult to pull off than in other industries. The reason is that in medicine doctors decide the treatment plan, while the family of the patient pays the fee, and the patient receives the treatment, which means that Professor Sun has to convince doctors to adopt his technique. This generates an obstacle in employing artificial organs in patients because generally a doctor feels more comfortable using a conventional treatment plan rather than a totally new one such as AnyHeart.

To solve this problem, more doctors are required to become involved in artificial organ research and thus experience the functionalities of the equipment. Similarly, more hospitals, especially research hospitals, should develop their own research artificial organs like the KAOC does.

Joint international research is also crucial, and Professor Sun especially emphasizes the cooperation between Korea, Japan and China. The reason is that each medical community has their own merits. Korea has great facilities and medical laws that can facilitate new medical research; Japan has state-of-the-art artificial organ prototypes that Professor Sun praises as “pieces of art,” last but not least, China has the necessary medical research funding. Therefore, cooperation between these three countries could be capable of shifting the paradigm of the global medical community.

Professor Sun and KAOC still have a long way to go to accomplish their dreams. Nevertheless, artificial organs are gaining as more relevant institutions are established around the globe. In the future, close or distant, people with organ failures will not need to wait for an organ donation. Rather, they will survive and continue to live thanks to artificial organ implants that will support their life permanently.