International Journal of Artificial Organs最新文献

{"title":"Depurative capacity toward medium molecules of the dialyzer Toray NV-U^® Hydrolink™: A new hydrophilic membrane to perform online hemodiafiltration.","authors":"Maria Kislikova, Almudena Vega, Eduardo Verde, Soraya Abad, Marco Vaca, Adriana Acosta, Angela González, Arturo Bascuñana, Antonia Mijailova, Coraima Nava, Miguel Villa, Juan Carlos Ruiz, Marian Goicoechea","doi":"10.1177/03913988241274735","DOIUrl":"10.1177/03913988241274735","url":null,"abstract":"<p><strong>Introduction: </strong>New dialysis membranes with new properties are being developed to improve efficacy and tolerance. The hemocompatibility of a polymeric biomaterial is influenced by the layer of water at the blood membrane interface. The new dialyzer TORAY NV-U^® has a membrane Hydrolink™, designed to suppress platelet adhesion and to improve the hemocompatibility. Until now, there is no experience in online hemodiafiltration (OL-HDF).The objective of the present study is to evaluate the efficacy of this new membrane in OL-HDF therapy compared to another membrane commonly used. Other objectives are to evaluate the inflammatory response, hemodynamic tolerance, and the anticoagulation regimes.</p><p><strong>Methods: </strong>This is a prospective pilot study performed in five anuric patients receiving OL-HDF. For 1 month patients were kept with their usual dialyzer FX1000^® (FMC). Subsequently, the dialyzer was changed to TORAY NV-U^® (Hydrolink^®) for 1 month. In the last dialysis session of each dialyzer, blood tests were performed to evaluate inflammation and depurative capacity.</p><p><strong>Results: </strong>We did not find differences in medium size removal molecules and convective volume: FX1000^®: 31 ± 9 l per session and Hydrolink™ 30 ± 8 l; <i>p</i> = 0.7); β2microglobulin reduction ratio (RR) FX1000^® FMC 83 ± 3%; Hydrolink™ 79 ± 4; <i>p</i> = 0.14; Myoglobin RR FX1000^® FMC 72 ± 7%; Hydrolink™ 76 ± 4; <i>p</i> = 0.28. We did not find differences in inflammation parameters: serum IL6 with FX1000^® 6.0 ± 4.2 pg/mL; Hydrolink™ 7.6 ± 5.0 pg/mL; <i>p</i> = 0.3.During all sessions with the two dialyzers there was adequate plasmatic filling, reaching 85 % filling. All patients had \"good\" dialyzer status in all dialysis sessions with TORAY NV-U^®, while the dialyzer status with FX1000^® was \"good\" in 20% of the sessions, \"medium\" in 30%, and \"dirty\" in the remaining 50% dialysis sessions.</p><p><strong>Conclusions: </strong>The new dialyzer Hydrolink™, TORAY NV-U^® is not inferior to perform OL-HDF compared to dialyzers usually used for this therapy, and could allow decrease heparin doses. Further studies with a bigger sample size and longer follow-up will answer if Hydrolink improves inflammation and assess a better hemodynamic tolerance.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"795-801"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142286391","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":"Investigation of the acute effect of the synthetic hemodialysis membrane on the expression of <i>XRCC1</i> and <i>PARP1</i> in chronic hemodialysis patients.","authors":"Selin Unal, Serkan Feyyaz Yalin, Mehmet Riza Altiparmak, Bahadir Batar, Mehmet Guven","doi":"10.1177/03913988241288379","DOIUrl":"10.1177/03913988241288379","url":null,"abstract":"<p><strong>Objective: </strong>The interaction between blood from end-stage renal failure patients undergoing hemodialysis treatment and the hemodialysis (HD) membranes used may lead to DNA damage, contingent upon the biocompatibility of the membranes. Given that this process could impact the disease's course, it is crucial to assess the efficacy of DNA repair mechanisms.</p><p><strong>Methods: </strong>In our study, we investigated the gene expression levels of <i>XRCC1</i> and <i>PARP1</i> enzymes, which are involved in the base excision repair (BER) repair mechanism crucial for repairing oxidative DNA damage, in 20 end-stage renal disease (ESRD) patients undergoing HD treatment both before and after dialysis sessions. Additionally, we compared our findings with those from 20 healthy controls. We assessed gene expression levels using real-time polymerase chain reaction (qRT-PCR).</p><p><strong>Results: </strong>We observed that the HD process utilizing a polysulfone membrane did not impact the expression levels of genes. However, we noted a lower expression level of the <i>PARP1</i> gene in ESRD patients undergoing HD compared to the control group (0.021 ± 0.005 vs 0.0019 ± 0.0013, <i>p</i> = 0.0001).</p><p><strong>Conclusion: </strong>Although our study findings indicate that HD membranes do not affect gene expression overall, the specific decrease in PARPI gene expression suggests that the effectiveness of the BER DNA repair mechanism is impaired in ESRD patients, which may play a significant role in the progression of the disease.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"810-815"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142557797","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":"Freezing and bioreactor in the low-concentration detergents: A novel approach in the decellularization of small-diameter arteries.","authors":"Nho Thuan Nguyen, Hoang Minh Lam, Thang Quoc Bui, Ha Le Bao Tran","doi":"10.1177/03913988241288369","DOIUrl":"10.1177/03913988241288369","url":null,"abstract":"<p><p>Using decellularized small-diameter vascular bypass substitutes (<6 mm) is an efficient method for bypass grafting. A solution containing 0.5% SDS (weight/volume) is commonly used for extended periods to generate acellular tissues. However, this solution causes damage to the microfibril structure and alters the mechanical forces. Hence, the objective of this study is to reduce the concentration of SDS to preserve the structure and achieve efficient decellularization. The study employs a diluted solution of 0.3% SDS (weight/volume) to treat fresh and frozen swine small-diameter arteries, utilizing physical methods such as freezing and thawing. The effectiveness of cell removal was evaluated using histological analysis and the remaining DNA content of the sample. Furthermore, the acellular circuit also assesses the cytotoxicity and proliferation of HUVECs to gauge their safety. Through the use of 0.3% SDS, a bioreactor system, and freezing-thawing, the pig arteries are successfully decellularized, resulting in residual DNA levels of less than 50 ng/mg dry weight. This process does not cause any major changes to the biomechanical or structural properties of the arteries. The acellular samples exhibit no toxicity on the L929 cell line and promote the growth of HUVECs at their highest rate on the fourth day. This allows for the placement of acellular vascular grafts to evaluate physiological processes within the animal body. This is an important requirement in clinical blood vessel transplantation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"816-825"},"PeriodicalIF":16.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464546","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 effect of changes in intra-compartmental bioimpedance measurements with early intra-dialytic hypotension during haemodialysis.","authors":"Sabrina Haroon, Andrew Davenport","doi":"10.1177/03913988241269444","DOIUrl":"10.1177/03913988241269444","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-dialytic hypotension (IDH) remains the commonest problem associated with routine haemodialysis treatments. Fluid shifts from intracellular(ICW) and extracellular(ECW) compartments to refill plasma volume during haemodialysis with ultrafiltration.</p><p><strong>Methods: </strong>We studied the effect of relative changes in ICW and ECW indifferent body segments using multifrequency segmental bioimpedance during haemodialysis and IDH episodes.</p><p><strong>Results: </strong>Of 42 haemodialysis patients,16 patients (38.1%) developed IDH within the first hour of dialysis. Patients with and without early IDH were well-matched for demographics and starting bioimpedance measurements. However, after 60 min, the relative change in in ECW/ICW ratio between the non-fistula arm and leg was significantly different for the early IDH group median -1.07 (-3.33 to 0.8) versus 0.61 (-0.78 to 1.8), <i>p</i> < 0.05, whereas there no differences in ultrafiltration rate, relative blood volume monitoring or on-line clearance.</p><p><strong>Conclusion: </strong>Monitoring serial changes in fluid status in different body compartments with bioimpedance may potentially prevent IDH in the future.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"802-809"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008770","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":"Extracorporeal membrane oxygenation ameliorate hepatic injury in brain death rat donors with hemodynamic instability.","authors":"Jianbao Yang, Jian Li, Awang Zhuoga, Zeyuan Yu, Yongnan Li, Zuoyi Jiao","doi":"10.1177/03913988241278189","DOIUrl":"10.1177/03913988241278189","url":null,"abstract":"<p><strong>Background: </strong>Donation after brain death (DBD) serves as the primary source for liver transplantation. However, livers obtained through DBD often incur damage due to unstable hemodynamics, potentially impacting transplantation outcomes. Extracorporeal Membrane Oxygenation (ECMO) emerges as an optimal technique for donor liver retrieval and has found application in clinical settings. Despite its clinical implementation, the precise mechanisms through which ECMO enhances liver functions remain elusive. This study aims to investigate the mechanisms underlying how ECMO ameliorates liver function in brain-dead donors.</p><p><strong>Methods: </strong>We randomly assigned 18 male Sprague-Dawley (SD) rats (350 ± 50 g) into three groups: Con (<i>n</i> = 6), DBD-assisted drug (<i>n</i> = 6), and DBD-assisted ECMO (<i>n</i> = 6). After 3 h of ECMO, the rats were sacrificed. We assessed and compared changes in heart rate, blood pressure, cumulative liver damage (evaluated through HE and TUNEL staining), serum levels of AST and ALT, alterations in serum oxidative stress factors (MDA, H2O2, SOD, and 8-OHdG), and serum concentrations of related inflammatory factors (interleukin [IL]-1β, IL-6, IL-8, and TNF-α) among rats in the Con, DBD-assisted drug, and DBD-assisted ECMO groups. Subsequently, we established a rat orthotopic liver transplantation (OLT) model and transplanted livers obtained through the aforementioned methods. The post-transplantation status of the livers was observed.</p><p><strong>Results: </strong>After 3 h of brain death, liver injury worsened, accompanied by a significant increase in serum transaminases, inflammatory responses, oxidative stress, and TUNEL staining. Strikingly, ECMO not only stabilized hemodynamics after DBD but also mitigated liver damage, leading to an alleviated status post liver transplantation.</p><p><strong>Conclusions: </strong>ECMO stabilizes hemodynamics, attenuates inflammatory responses and oxidative stress, thereby enhancing the quality of liver grafts for transplantation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"836-846"},"PeriodicalIF":16.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464536","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":"ECMO in severe hypoxemia post liver transplant for hepatopulmonary syndrome.","authors":"Jesús Emilio Barrueco-Francioni, María Carmen Martínez-González, Juan Francisco Martínez-Carmona, María Palma Benítez-Moreno, Cesar Aragón-González, Manuel Enrique Herrera-Gutiérrez","doi":"10.1177/03913988241274252","DOIUrl":"10.1177/03913988241274252","url":null,"abstract":"<p><p>Hepatopulmonary syndrome (HPS) poses a significant challenge in liver transplant patients, affecting between 10% and 30% of candidates. Historically, HPS was considered a contraindication for liver transplantation due to its association with high mortality rates. However, recent studies have shown improvements in pulmonary function post-transplant, leading to the inclusion of these patients as candidates. Despite this progress, approximately one-fifth of liver transplant recipients develop severe postoperative hypoxia, further complicating their clinical course and contributing to increased mortality. The management of post-transplant HPS involves various strategies, including extracorporeal membrane oxygenation (ECMO), although its use remains infrequently reported. Theoretical models suggest that oxygenation typically improves within 10 days post-transplant, while resolution of HPS may take 6-12 months, making ECMO an attractive possibility as a bridge to recovery in this population. We present a case were ECMO was used in this context.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"858-861"},"PeriodicalIF":1.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107096","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":"Regional citrate anticoagulation versus LMWH anticoagulation for CRRT in liver failure patients without increased bleeding risk.","authors":"Siyan Tang, Yan Yu, Siwei Tang, Tong Liu, Hao Wu, Yi Liu, Lijuan Zhao, Rui Lu, Peng Zhang, Ming Bai","doi":"10.1177/03913988241269492","DOIUrl":"10.1177/03913988241269492","url":null,"abstract":"<p><strong>Background: </strong>The optimal anticoagulation regimen for continuous renal replacement therapy (CRRT) in liver failure (LF) patients without increased bleeding risk remains controversial. Therefore, we conducted a monocentric retrospective study to evaluate the efficacy and safety of the regional citrate anticoagulation (RCA) versus low molecular weight heparin (LMWH) anticoagulation for CRRT in LF without increased bleeding risk.</p><p><strong>Method: </strong>According to the anticoagulation strategy for CRRT, patients were divided into the RCA and LMWH-anticoagulation groups. The evaluated endpoints were patient survival, filter lifespan, bleeding, citrate accumulation, and totCa/ionCa ratio.</p><p><strong>Result: </strong>Totally 167 and 164 filters were used in the RCA and LMWH group, respectively. The median filter lifespan was significantly longer in the RCA group (34 h (IQR = 24-54) versus 24 h (IQR = 18-45.5) [95%CI, 24.5-33]; <i>p</i> < 0.001). The 4-week mortality rate was significantly higher in the LMWH-anticoagulation group (71 (57.72%) vs 53 (40.46%); <i>p</i> = 0.006). After adjusted the important parameters in the multivariate COX regression model, the mortality risk was significantly reduced in the RCA group (HR = 0.668 [95%CI, 0.468-0.955]; <i>p</i> = 0.027). In the LMWH group, 30 bleeding episodes (24,19%) were observed, whereas only 7 (5.34%) occurred in the RCA group (<i>p</i> < 0.001). Two patients (1.5%) in the RCA group occurred citrate accumulation.</p><p><strong>Conclusions: </strong>In LF patients without increased bleeding risk who underwent CRRT, RCA significantly extended the filter lifespan and improved patient survival rate. There was no significant difference in the rate of adverse events between the two groups.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"756-764"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046635","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":"How I treat rhabdomyolysis-induced AKI? A different perspective.","authors":"Gabriella Bottari, Isabella Guzzo","doi":"10.1177/03913988241269508","DOIUrl":"10.1177/03913988241269508","url":null,"abstract":"","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"721-722"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119744","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":"A cavalpulmonary assist device utilising impedance pumping enhanced by peristaltic effect.","authors":"Arthur P Burns-Cox, Lian Gan, Ashraf W Khir","doi":"10.1177/03913988241268419","DOIUrl":"10.1177/03913988241268419","url":null,"abstract":"<p><strong>Background: </strong>Fontan procedure, the standard surgical palliation to treat children with single ventricular defects, causes systemic complications over years due to lack of pumping at cavopulmonary junction. A device developed specifically for cavopulmonary support is thus considered, while current commercial ventricular assist devices (VAD) induce high shear rates to blood, and have issues with paediatric suitability.</p><p><strong>Aim: </strong>To demonstrate the feasibility of a small, valveless, non-invasive to blood and pulsatile rotary pump, which integrates impedance and peristaltic effects.</p><p><strong>Methods: </strong>A prototype pump was designed and fabricated in-house without any effort to optimise its specification. It was then tested in vitro, in terms of effect of pumping frequency, background pressure differences and pump size on output performance.</p><p><strong>Results: </strong>Net flow rate (NFR) and maximum pressure head delivery are both reasonably linearly dependent on pumping frequency within normal physiological range. Positive linearity is also observed between NFR and the extent of asymmetric pumping. The device regulates NFR in favourable pressure head difference and overcomes significant adverse pressure head difference. Additionally, performance is shown to be insensitive to device size.</p><p><strong>Conclusions: </strong>The feasibility of the novel rotary pump integrating impedance and peristaltic effects is demonstrated to perform in normal physiological conditions without any optimisation effort. It provides promising results for possible future paediatric cavopulmonary support and warrants further investigation of miniaturisation and possible haemolysis.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"765-773"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107095","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":"Evaluation of the relationship between proximal upper-extremity arteriovenous fistula patency and atherogenic index of plasma.","authors":"Arda Aybars Pala, Yusuf Salim Urcun, Cengiz Guven","doi":"10.1177/03913988241269534","DOIUrl":"10.1177/03913988241269534","url":null,"abstract":"<p><strong>Background: </strong>The continuity of arteriovenous fistula (AVF) patency is essential for effective hemodialysis. In the present study, we aimed to investigate the relationship between AVF patency and atherogenic index of plasma (AIP) in patients with native proximal upper-extremity AVF.</p><p><strong>Methods: </strong>A total of 143 patients with native proximal upper-extremity AVF created in our clinic between January 2014 and April 2022 were analyzed retrospectively. Those with at least 24 months of follow-up and intact AVF were defined as \"Group 1\" (<i>n</i> = 97), and those with AVF thrombosis were defined as \"Group 2\" (<i>n</i> = 46).</p><p><strong>Results: </strong>The primary patency rates of the patient groups included in the study were found to be 88.1% at 6th month, 79% at 12th month, and 67.8% at 24th month. The mean AIP values that were calculated in Group 2 were found to be statistically significantly higher than the mean value calculated in Group 1 (0.30 ± 0.12 vs 0.20 ± 0.10, <i>p</i> < 0.001). In a multivariate logistic regression analysis made to identify the predictors of proximal upper-extremity AVF thrombosis development, total cholesterol (OR [odds ratio] = 2.259, 95% CI [confidence interval] = 1.468-3.475, <i>p</i> < 0.001), and triglyceride (OR = 13.777, 95% CI = 3.740-50.750, <i>p</i> < 0.001) were identified as independent predictors.</p><p><strong>Conclusion: </strong>A significant relationship was detected in the analyses between the easily calculated AIP values and the development of AVF thrombosis. The AIP is a remarkable preoperative parameter regarding proximal upper-extremity AVF patency.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"743-748"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046634","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}