International Journal of Artificial Organs最新文献

{"title":"Hemolysis testing in circulatory support pumps: Standards, mock loops, and pulsatility.","authors":"Sung-Min Park, Seong-Wook Choi","doi":"10.1177/03913988261446074","DOIUrl":"https://doi.org/10.1177/03913988261446074","url":null,"abstract":"<p><p>Hemolysis evaluation is central to the safety assessment of blood pumps and extracorporeal circulatory support, yet clinically relevant hemolysis continues to occur despite widespread use of standardized in vitro frameworks. A major contributor to this gap is that LVAD and VA-ECMO operate under intrinsically pulsatile and transient hemodynamic conditions that are not fully represented by steady or quasi-steady test protocols. This narrative, methods-focused review synthesizes recent in vitro hemolysis testing literature with an emphasis on pulsatility-aware evaluation. We highlight limitations of conventional large-volume loops and summarize emerging approaches that enable more interpretable benchmarking, including reduced-volume paired-loop testing, hybrid mock circulatory loops (HMCL) that reproduce heart-pump interaction, and quantitative descriptors for defining pulsatility. In addition, key operating and blood-handling descriptors required for reproducible interpretation across test platforms are organized to clarify minimum reporting requirements. Together, these considerations support the development of in vitro hemolysis evaluation frameworks that better reflect clinical operating conditions and facilitate objective comparison of pulsatile blood-pump technologies.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261446074"},"PeriodicalIF":1.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global research trends in artificial kidneys (2014-2024): A bibliometric and visualization study.","authors":"Tao Ye, FuQiang Li, DeSheng Zhu","doi":"10.1177/03913988261437350","DOIUrl":"https://doi.org/10.1177/03913988261437350","url":null,"abstract":"<p><p>When renal function is lost following resection of renal tumors, in the setting of end-stage kidney disease, or after traumatic nephrectomy, kidney transplantation is typically required; however, owing to constraints in healthcare resources, only a minority of patients can access transplantation. In this context, the development of efficient artificial kidneys as alternative therapies may help alleviate donor scarcity and holds potential clinical applicability, underscoring the substantial significance of this research. In the present study, a bibliometric analysis was conducted on the global literature in the field of artificial kidneys from 2014 to 2024, delineating overall developmental trends and technological hotspots. The findings indicate a marked increase in publications related to artificial kidneys over the past decade, with the field evolving from conventional renal replacement therapies toward a multidisciplinary paradigm integrating medicine, engineering, and artificial intelligence. The United States and other countries have made prominent contributions, and collaboration among multiple institutions has become increasingly frequent. Key research hotspots include the use of artificial intelligence in kidney-disease prediction models and clinical decision support, the development of implantable or wearable fully functional artificial kidneys, and advances in bioartificial kidneys and tissue-engineering technologies. The results further suggest that artificial-kidney technologies are entering a new stage characterized by increasing intelligence and convergence with biological and tissue-engineering approaches. Progress in novel immunomodulatory materials and biosensing technologies is expected to facilitate the development of artificial kidneys with therapeutic efficacy approaching that of kidney transplantation. This analysis provides an important reference for researchers, may help guide future research directions and promote cross-disciplinary collaboration, and ultimately may accelerate the realization of an ideal artificial kidney and improve the prognosis of patients with end-stage kidney disease.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261437350"},"PeriodicalIF":1.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of computed tomography angiography in evaluating autogenous arteriovenous fistula dysfunction in haemodialysis patients.","authors":"Lihua Ma, Lijiao Wen, Xiaofei Xing, Xiaoyu Sun, Dongke Li, Qi Li","doi":"10.1177/03913988251415095","DOIUrl":"https://doi.org/10.1177/03913988251415095","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the diagnostic performance and clinical value of computed tomography angiography (CTA) in assessing postoperative restenosis of arteriovenous fistulas (AVFs), and to analyse the correlation between stenosis severity and post-intervention outcomes.</p><p><strong>Methods: </strong>This single-centre retrospective study included 102 patients (63% male; mean age: 59.2 years) with dysfunctional upper-limb autogenous arteriovenous fistulas undergoing haemodialysis, retrospectively analysed from April 2024 to February 2025. Computed tomography angiography-derived morphological parameters and prognostic data were collected.</p><p><strong>Results: </strong>In a diagnostic subset of 48 patients, CTA showed a sensitivity of 81%, specificity of 95% and overall accuracy of 88% for detecting ⩾50% stenosis compared with digital subtraction angiography (DSA). Moderate to severe stenosis (Grade 4-6) was found in 98% of cases, predominantly at the anastomotic site (83%). Thrombosis or collateral abnormalities occurred in 27% of cases. Balloon angioplasty was performed in 92%, restoring blood flow (400-600 mL/min) in 94%, with 86% achieving good functional recovery. Stenosis severity correlated with blood flow improvement (<i>r</i> = 0.253, <i>p</i> = 0.012) and functional recovery (<i>r</i> = 0.493, <i>p</i> = 0.029).</p><p><strong>Conclusion: </strong>Computed tomography angiography effectively assesses AVF stenosis and guides interventions, though its long-term prognostic value warrants further study.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988251415095"},"PeriodicalIF":1.3,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updating aims and scope of IJAO: Artificial organs, medical technology and biomedical engineering.","authors":"Andrea Remuzzi","doi":"10.1177/03913988261437295","DOIUrl":"https://doi.org/10.1177/03913988261437295","url":null,"abstract":"","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261437295"},"PeriodicalIF":1.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fabrication and biological evaluation of a bioactive gelatin-sericin hydrogel for infected wound healing.","authors":"Senthil Rethinam, Felin Paul Paulraj, Geoffrey Sundar Edwin, Geetha Sravanthy Pelluru","doi":"10.1177/03913988261437251","DOIUrl":"https://doi.org/10.1177/03913988261437251","url":null,"abstract":"<p><p>Gelatin/sericin hydrogels (GSH) were developed as bioactive wound-care biomaterials due to their favorable biocompatibility, moisture retention, and inherent bioactivity. Their physicochemical characteristics and wound-healing efficacy were systematically evaluated. The hydrogels were prepared by blending gelatin and sericin, followed by crosslinking, and characterized using Fourier-transform infrared spectroscopy (FTIR) and High-resolution scanning electron microscopy (HRSEM), along with antimicrobial activity, MTT cytocompatibility assay, histological (H&E) analysis, and in vivo zebrafish wound-healing studies. FTIR confirmed successful integration of gelatin and sericin through characteristic amide bands and enhanced hydrogen bonding, while HRSEM revealed a uniform porous architecture with interconnected microstructures. The GSH exhibited pronounced antimicrobial activity, with inhibition zones of 34.5 ± .5 mm against <i>S. mutans</i> and 10.2 ± 0.4 mm against <i>P. aeruginosa</i>, comparable to those of the gentamicin controls. Cytocompatibility was confirmed by >90% cell viability in MTT assays, and in vivo zebrafish models demonstrated significantly enhanced wound closure (72% by day 5) compared with untreated controls (38%). Collectively, these findings highlight the promising potential of GSH as a biocompatible, antimicrobial, and pro-healing hydrogel for wound management applications.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261437251"},"PeriodicalIF":1.3,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Body temperature trends during continuous renal replacement therapy according to different warming approaches: A prospective observational study.","authors":"Elif Bulbul, Sema Yildirim","doi":"10.1177/03913988261429924","DOIUrl":"https://doi.org/10.1177/03913988261429924","url":null,"abstract":"<p><strong>Aim: </strong>To describe and compare temperature trends observed during continuous renal replacement therapy (CRRT) among patients receiving different warming approaches in routine clinical practice.</p><p><strong>Methods: </strong>Prospective observational study. Eighty-nine adult patients undergoing CRRT were assigned to one of three warming approaches. Core body temperature was recorded hourly for 8 h.</p><p><strong>Results: </strong>Mean body temperature decreased slightly over the 8-h period overall. Both active warming strategies maintained significantly higher temperatures compared to no warming. After adjustment for baseline temperature covariate, warming method remained a significant independent predictor of mean body temperature. The extracorporeal blood warming unit demonstrated the highest adjusted mean temperature and the greatest thermal stability over time. In contrast, the control group showed a progressive decline in temperature.</p><p><strong>Conclusions: </strong>Active warming strategies significantly improve thermal stability during CRRT, independent of baseline temperature. Extracorporeal blood warming appears superior to passive warming methods. These findings support routine integration of active warming devices into CRRT protocols to prevent hypothermia.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261429924"},"PeriodicalIF":1.3,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Links between physical activity, time-in-range and glucose predictability in people with type 1 diabetes.","authors":"Marcos D Saavedra, Fernando A Inthamoussou, Emilia Fushimi, Fabricio Garelli","doi":"10.1177/03913988261435494","DOIUrl":"https://doi.org/10.1177/03913988261435494","url":null,"abstract":"<p><strong>Background: </strong>Type 1 diabetes (T1D) management remains particularly challenging in the presence of external disturbances such as stress or physical activity (PA). The glycemic impact of PA is still not fully understood and lacks standardized modeling approaches. This work seeks to describe the relationship between PA, time-in-range and glucose predictability in people with T1D (PwT1D).</p><p><strong>Methods: </strong>This study uses data from the Type 1 Diabetes and Exercise Initiative (T1DEXI) clinical trial, the largest trial to date in PwT1D undergoing both free-living and structured exercise. A characterization pipeline extracts summary statistics including glucose, carbohydrate intake and PA signals. These features are used to perform unsupervised clustering of subjects using various techniques. The relevance of the cluster-defining variables is then assessed, and their relationship to the performance of a long short-term memory (LSTM) neural network trained to forecast glucose 1 h into the future is analyzed.</p><p><strong>Results: </strong>The spectral clustering algorithm successfully separates individuals into three groups based on glycemic control metrics. Results indicate that subjects with higher levels of weekly PA exhibit lower prediction errors. This suggests that regular PA enhances the predictability of glucose trends, enabling more accurate forecasting models.</p><p><strong>Conclusion: </strong>Since fear of hypoglycemia remains one of the main barriers to PA in PwT1D, these findings are particularly relevant: regular exercise not only promotes better glycemic regulation but also improves the performance of predictive models, which could strengthen automated insulin delivery systems, support more reliable decision-support tools and contribute to safer and more confident engagement in PA.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261435494"},"PeriodicalIF":1.3,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the liver support systems OPAL and ALBUNIQUE in critically ill patients with liver dysfunction.","authors":"Aron Krause, Julia Leonhardt, Christian von Loeffelholz, Christoph Sponholz, Oliver Sommerfeld","doi":"10.1177/03913988261429916","DOIUrl":"10.1177/03913988261429916","url":null,"abstract":"<p><strong>Background: </strong>Liver dysfunction is a common phenomenon in critically ill patients. Extracorporeal albumin dialysis (ECAD) is established in supporting liver function as a bridge to transplant or recovery. ECAD device OPAL is confirmed in clinical routine and studied in terms of detoxification capabilities, efficacy and efficiency. For the ECAD device ALBUNIQUE, a further developed system requiring less specialised technical equipment, no corresponding literature is available.</p><p><strong>Methods: </strong>This retrospective single-center study included patients undergoing ECAD, either OPAL and/or ALBUNIQUE, in a two-year period from 2023 to 2024, with treatment times of 12 h or more. Generalized Estimating Equations were used to compare the effects of ECAD therapy.</p><p><strong>Results: </strong>In total, <i>n</i> = 25 patients with ECAD treatments were identified in our institution. Among these patients <i>n</i> = 90 ECAD cycles were eligible for evaluation, thereof <i>n</i> = 58 (64%) treatments with OPAL and <i>n</i> = 32 (36%) with ALBUNIQUE. ECAD treatment resulted in significant reduction of bilirubin, ammonia, creatinine, and urea levels as well as significant increase of negative base excess values. The first ECAD cycle was associated with highest percental changes. There were no significant differences between the parameters gathered by OPAL and ALBUNIQUE.</p><p><strong>Conclusion: </strong>Both ECAD systems, OPAL and ALBUNIQUE, were effective in removing bilirubin, reducing ammonia levels, eliminating water-soluble substances and stabilizing metabolic dysfunction without significant differences between the devices. Further, we found no increased bleeding risk during or after application of ECAD treatment in general or for one of the examined devices.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"241-249"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Removal of activated neutrophils by a polymyxin B-immobilized fiber (PMX) column.","authors":"Yohei Miyamoto, Ayuka Suzuki, Hiroki Otsuka, Ryosuke Kobayashi, Yumiko Sekiya, Yoko Koga, Hiroyuki Meguro, Nobuo Ida, Makiko Miyata","doi":"10.1177/03913988261429911","DOIUrl":"10.1177/03913988261429911","url":null,"abstract":"<p><strong>Background: </strong>Polymyxin B-immobilized fiber (PMX) columns are used to treat endotoxemic septic shock and have also been considered for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF), a condition defined by the absence of infection. Since the potential therapeutic effects beyond endotoxin adsorption remain unclear, we investigated the in vitro adsorption of various leukocyte subtypes using PMX columns under controlled stimulation.</p><p><strong>Methods: </strong>Whole blood from six healthy donors was treated with or without llipopolysaccharide (LPS) to model leukocyte activation. Leukocyte subsets and activation (CD11b⁺) were quantified by flow cytometric analysis before and after hemoperfusion through PMX or control columns. Removal capacity (%) and changes in neutrophil-to-lymphocyte ratio (NLR) were calculated.</p><p><strong>Results: </strong>The removal capacities of monocytes, granulocytes, and neutrophils were significantly higher with PMX column hemoperfusion than with the control column, with more pronounced effects after LPS stimulation. Lymphocyte removal was not significant. Activated CD11b⁺ granulocytes and neutrophils were preferentially removed by PMX columns. NLR was significantly reduced only by PMX columns, and the rate of change in NLR correlated with neutrophil removal, with a higher coefficient of determination in LPS-treated blood.</p><p><strong>Conclusions: </strong>PMX columns preferentially removed activated granulocytes/neutrophils and reduced NLR in vitro. These findings provide hypothesis-generating mechanistic insights into how PMX may modulate activated leukocyte profiles beyond endotoxin adsorption.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"227-234"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147616202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lactic alkalosis in a patient on veno-venous extracorporeal membrane oxygenation: A case report.","authors":"David K Carroll, Andrew M King, Brandtly Yakey, Aria Darling, Yusuke Terasaki, Simon N Carroll, Andrew R Isaacson","doi":"10.1177/03913988261439940","DOIUrl":"10.1177/03913988261439940","url":null,"abstract":"<p><strong>Background: </strong>Lactic alkalosis, defined as an increase in circulating lactate in the setting of elevated extracellular pH, has been described in both in vivo and in vitro settings, often under conditions of acute respiratory alkalosis. However, its occurrence in the context of extracorporeal membrane oxygenation (ECMO) has not been previously reported.</p><p><strong>Case summary: </strong>A 59-year-old man underwent coronary artery bypass grafting (CABG). Postoperatively, he developed respiratory failure necessitating veno-venous ECMO. Fluctuations in lactate were observed across ECMO circuit sampling points-pre-oxygenator, post-oxygenator, and arterial line-coinciding with changes in serum pH and PCO₂. Notably, lactate rose in tandem with an increase in pH and decrease in PCO₂ during increased sweep gas flow, consistent with ex-vivo lactic alkalosis.</p><p><strong>Conclusions: </strong>Lactic alkalosis is believed to result from proton-coupled lactate export via monocarboxylate transporters (MCT1), and enhanced glycolysis in erythrocytes due to pH-stimulated phosphofructokinase activity. Prior reports describe hyperlactatemia in patients with an acute respiratory alkalosis. This case adds novel ECMO-specific considerations: aggressive CO₂ clearance may rapidly shift pH and influence lactate kinetics ex vivo. To our knowledge, this is the first reported instance of lactic alkalosis temporally linked to ECMO sweep gas manipulation, highlighting a unique and benign biochemical artifact.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"264-266"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}