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Yan-Ting Shiu, a University of Utah internal medicine professor, is one of the nation’s leading researchers in hemodialysis vascular access and the most funded investigator by the NIH and VA in the field over the past 10 years.

But how did Shiu, who studied engineering in school, end up researching blood vessels and methods to improve the dialysis experience for patients with chronic kidney disease? She traces her inspiration back to a biography she read on a man who would become her hero.

Shiu grew up reading biographies and learning about different researchers, leading her to develop a love of engineering and science. While she was in college in Taiwan, she read a biography on the man widely known as the “father of artificial organs” and a longtime professor at the University of Utah, Willem Kolff.

One of Kolff’s earliest innovations was the first artificial kidney, which he built using sausage casings and barrels. This was the innovation that sparked Shiu’s dream to study treatment for kidney disease, and this dream was realized here at the U, the same university Kolff worked at for decades.

“I saw this doctor doing something that engineers do,” Shiu said. “That really left an impression in my mind that you can find a clinical problem that doesn't have a solution and come up with products and ideas to treat it.”

Shiu knew she wanted to improve the dialysis process and ended up specifically trying to address the issue of vascular access, combining her engineering knowledge with her doctorate and post doctorate work on blood vessels.  

Hemodialysis vascular access refers to the point on a patient’s arm where the needle is placed to draw the blood out of a vein for the dialysis machine to clean it and return the blood to the body. However, this process doesn’t always run smoothly. Occasionally, the vein gets blocked, often resulting in a trip to the ER. “We have one mission: keep access open,” Shiu said.

The Shiu lab poses in white coatsThe Shiu laboratory has trained over 80 undergraduate and graduate students from multiple departments and colleges across campus.

The patients Shiu hopes her research will help typically have a five-to-10-year life expectancy from the time they start dialysis, and the only cure for kidney failure is a transplant, which takes four years on average in the U.S. “While hemodialysis is by all means a lifesaving treatment, it is a treatment that is rather invasive,” Shiu said. “My research is really driven to how can we take care of these patients better.”

In addition to improving vascular access, Shiu and her lab, located in the Salt Lake City VA Medical Center, are researching ways to keep the blood vessels in patients with chronic kidney disease healthy and strong, so they don't develop cardiovascular disease. “The vessels are exposed to unclean blood, so they are the first line of victims,” Shiu said. “Oftentimes, chronic kidney disease patients die of a non-kidney related disease.”

Applying engineering principles to kidney disease

Shiu is one of the few engineers studying vascular access, and that affects how she approaches her research. “Engineers are trained to see the world in terms of the laws of physics, math or biology,” she said.

She also said engineers are less focused on how a molecule works than a basic scientist or medical doctor and more focused on how to use that molecule or tool to solve a problem. For example, Shiu worked with collaborators at the University of Chicago to apply a specific type of nanoparticle to vascular access. The nanoparticle delivers the drugs directly to the vascular access area rather than the whole body. “I feel drug treatment is really an engineering problem of how to deliver drugs to where it’s needed,” she said.

Shiu and her colleagues worked with both the U’s Technology Licensing Office and Chicago’s tech transfer office to file for a patent to protect the nanoparticles, and the team learned an important lesson in intellectual property protection.

“By the time we reached out to the patent officer, we had already presented some of our findings in conferences, and we were about to write a paper,” Shiu said. “We talked to the patent lawyer, and they stopped us right there.”

How does TLO decide what to patent?

The United States Patent and Trademark Office consider conference presentations and papers to be public disclosures, and these disclosures can hamper the possibility of receiving a patent considerably because a patented invention must be “novel.” The USPTO does allow inventors to file a patent application within one year of the public disclosure, so for Shiu and her team the clock started with the conference presentations.

Shiu encouraged both basic and applied scientists to seek out advice and training from the Technology Licensing Office to become familiar with intellectual property protection to ensure their innovations are safeguarded and can reach their full potential.

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