HOSPITAL DESIGN AND CONSTRUCTION
Inside the ‘world’s first’ organ regeneration lab
John Gregory, a former journalist, and a partner at Toronto-based CGC Educational Communications, describes work to design and build and what is said to be the world’s first organ regeneration laboratory, at Toronto General Hospital in Canada. A senior redevelopment director at the new facility says the procedures undertaken there will ‘change what is done across the planet’.
The largest health research organisation in Canada had one chance to get it right – ‘it’ being building two mini-operating rooms (ORs) in a live suite of 20 sterile ORs. “We’re talking about a city of individuals that are having different surgeries in 16 to 18 ORs at any one time,” said Christopher Rizzo, Executive director of redevelopment at the University Health Network (UHN). Complicating the endeavour was the pandemic. “The first day we did our site review was the day COVID hit,” explained Keith Button, Senior architectural designer at Kearns Mancini Architects (KMAI). “We were on site when everything locked down. We had to get the director of Infection Control at UHN to help us exit the hospital.” Not the typical start to a new project, but then
again this is among the most unique projects on the planet. Christopher Rizzo and Keith Button are specifically
speaking about the design and building of the world’s first organ regeneration laboratory (ORL) at Toronto General Hospital (TGH), the number one transplant hospital in North America. The TGH transplant surgeons who developed the regeneration technologies had been honing their techniques in an existing operating room. Such ORs can be up to 700 to 1,200 ft2
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in size, so it was
overkill for their spatial needs, and not the best use of precious hospital resources. They brought the concept of a dedicated lab to Christopher Rizzo.
Organ regeneration using ‘perfusion’ technology In the past, if organs were in any sort of trauma, they couldn’t be transplanted. The organ regeneration lab is using technology that was perfected at Toronto General; it’s called perfusion. Perfusion effectively keeps the organ alive for an extended period in a specialised environment like an incubator, which gives the team time to work on it and get the organ ready for transplant. “These are the projects you do once in your life,” said Christopher Rizzo. “We now have two designated mini-ORs that have created the ability to regenerate or repair organs for transplant. There’s a third area, which is called the islet room, that harvests stem cells from a pancreas, and is being used to treat diabetes, reversing the effect of the disease in some patients.” Toronto General completes 1,200-1,400 transplants a
year, with a success rate hovering around 98%. “We’re in pretty esteemed company on a global scale,” said Christopher Rizzo. “We were the first to transplant a lung
and double lungs. Right now, if a recipient needs double lungs, they are getting them in one operation. Our track record is probably the best you can get for surviving major transplants.”
Challenges of breaking ground Groundbreaking work is being done in these facilities, but breaking ground to build them was challenging. “It was like playing Tetris in a fully functioning operating ward,” said Keith Button. “We couldn’t do one thing without it affecting something else. We had to free up three rooms that were already in use – one for perfusionists, another for anaesthetists, and an equipment storage room. Just to free up these three rooms we had to renovate 12 locations in the hospital, most of them in the operating suite itself.” Due to the tight schedule and a need for experienced
Top: Toronto General completes 1,200-1,400 transplants a year, with a success rate ‘hovering around 98%’.
Above: Toronto General Hospital now has two designated ‘mini-ORs’ that have created the ability to regenerate or repair organs for transplant.
November 2024 Health Estate Journal 45
Photos used courtesy of Tom Ridout
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