International Journal of Artificial Organs最新文献

{"title":"Rapid inkjet resorbable plate scaffold 3D bioprinting technology.","authors":"Vyacheslav R Shulunov","doi":"10.1177/03913988261471402","DOIUrl":"https://doi.org/10.1177/03913988261471402","url":null,"abstract":"<p><p>A new principle has been developed that is orders of magnitude superior to the all main 3D bioprinters. Its specifications are comparable to the breakthrough Roll Porous Scaffold 3D bioprinting technology (cell density ~1.5 × 10⁸ cell/mL, performance ~1.8 L/h, precision up to ~2500 DPI (~10 µm) for UV laser and submicron for Blu-ray one, but it is simpler. Substantial increase in the velocity of formation of solid organoid relative to conventional technique occurs due to the absence of pauses for the formation of scaffolds using stereolithography and extrusion. A new way based on prefabricated plates with two biodegradable lattice layers that dissolve quickly and slowly. The 1st mesh layer are designed to hold several cells, while the 2nd one act as a reinforcing base and filter, increasing the inkjet printing density with longer fill exposures for inkjet filling. The perimeter of the plates is made of incompressible material and controls the height of the layer of the formed bioobject when they are stacked.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261471402"},"PeriodicalIF":1.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684532","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":"Hemoperfusion integrated into the cardiopulmonary bypass circuit modifies perioperative inflammatory trajectories.","authors":"Biao Zhang, Longlong Li, Hui Li, Jing Li, Haitao Liu","doi":"10.1177/03913988261473119","DOIUrl":"https://doi.org/10.1177/03913988261473119","url":null,"abstract":"<p><strong>Background: </strong>Hemoperfusion has emerged as a potential extracorporeal blood purification strategy for attenuating inflammation during cardiopulmonary bypass (CPB), but perioperative biomarker trajectory data remain limited. This pilot comparative study evaluated whether integration of the HA380 cartridge into the CPB circuit was associated with altered postoperative inflammatory kinetics in adult cardiac surgery.</p><p><strong>Methods: </strong>In this single-center, nonrandomized, biomarker-focused pilot study, 60 adult patients undergoing cardiac surgery with CPB were included, with 30 patients receiving HA380 hemoperfusion during CPB and 30 patients managed with conventional CPB alone. Serum levels of TNF-α, IL-1β, IL-6, IL-8, IL-10, and C-reactive protein (CRP) were measured at four standardized perioperative time points: T0 (preoperative baseline), T1 (end of surgery/ICU admission; 0 h), T2 (postoperative 24 h), and T3 (postoperative 48 h). Because treatment allocation was not randomized and baseline inflammatory imbalance was present, change-from-baseline and trajectory analyses were prioritized.</p><p><strong>Results: </strong>The HA380 group entered surgery with a numerically higher baseline inflammatory burden. However, by postoperative 24 h and 48 h, most proinflammatory biomarkers in the HA380 group showed a downward trajectory or remained near baseline, whereas the control group demonstrated persistent postoperative elevation. This pattern was more clearly captured by change-from-baseline analyses than by crude postoperative absolute values alone. The composite inflammatory burden score decreased postoperatively in the HA380 group but increased progressively in the control group, supporting a global attenuation of inflammatory propagation rather than an isolated effect on a single cytokine.</p><p><strong>Conclusions: </strong>In this biomarker-focused pilot study, HA380 hemoperfusion integrated into the CPB circuit was associated with a more favorable postoperative inflammatory trajectory. These findings support the biologic plausibility of intraoperative hemoperfusion as an adjunct extracorporeal modulation strategy and justify further validation in larger studies.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261473119"},"PeriodicalIF":1.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684338","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":"A regional partnership model for VA-ECMO initiation and transfer from remote centers using air medical transport.","authors":"Collin Barrett, Maroun Chedid, Katherine Christl, Kristin Irwin-Crouse, Greg Kerola, Kyle Kaiser, Katarzyna Hryniewicz","doi":"10.1177/03913988261471406","DOIUrl":"https://doi.org/10.1177/03913988261471406","url":null,"abstract":"<p><p>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has become an accepted treatment modality for refractory cardiogenic shock (CS). However, its use is limited to tertiary centers due to resource allocation, education, and personnel requirements. The cannulate-and-ship model has therefore emerged to extend access to VA-ECMO. This model faces several communication, education, and logistical challenges. We describe the safety and early outcomes of a regional VA-ECMO training and air medical transport program that uses a text-message-based communication protocol and an \"always open\" VA-ECMO transfer status. In this retrospective descriptive study, 14 patients were cannulated at rural or limited-resource hospitals and transported by air to a tertiary ECMO center between October 2024 and December 2025. Median transport distance was 440 km. All patients survived transport without transport-related complications. Survival to VA-ECMO decannulation was 86%, to hospital discharge 79%, and 30-day survival from cannulation was 69%. These findings suggest that our structured regional program, incorporating simulation-based training, centralized consultation and communication, and perfusionist-supported transport, may safely extend VA-ECMO access to remote hospitals while addressing communication and logistical barriers.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261471406"},"PeriodicalIF":1.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684407","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":"Scoping review of fatigue assessment tools for hemodialysis patients: Focusing on clinical application, psychometric properties and Chinese localization.","authors":"Jun Chen, Lingao Wu","doi":"10.1177/03913988261473112","DOIUrl":"https://doi.org/10.1177/03913988261473112","url":null,"abstract":"<p><p>Fatigue is a common symptom in hemodialysis (HD) patients, and effective assessment is crucial for management. While there are various assessment tools, clinical consensus on their selection is lacking. Most reviews focus on the introduction of tools but overlook systematic evaluations of their psychometric properties, and there is limited focus on localization challenges in Chinese clinical practice. This review systematically evaluates the status of fatigue assessment tools for HD patients, their psychometric properties, and the needs for optimizing their application in Chinese localization. The system searched Chinese and English databases, including CNKI, Wanfang, Web of Science, PubMed, Embase, and CINAHL, from their inception to September 30, 2025, for literature on fatigue assessment tools for HD patients. A scoping review method was used for systematic summarization. A total of 38 articles were included, involving 13 fatigue assessment tools for HD patients, including 1 objective assessment tool and 12 subjective self-assessment scales, namely FSS, SF36-V, CFS, MFI-20, VAFS, FACIT-F, RPFS, BFI, PROMIS, PFS-12, PDF, and SONG-HD. These tools varied in dimensions, recall periods, adaptation status, and usage frequency. While some showed good reliability, most still lacked robust evidence for construct and cross-cultural validity. Clinically, tools should be chosen based on scenarios like screening, evaluation, or research. In China's HD field, fatigue assessment needs to transition from using borrowed tools to culturally adapted ones. Existing Chinese tools should be revalidated per international standards, and a core assessment system should be developed to align with the cultural and clinical context of Chinese patients.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"3913988261473112"},"PeriodicalIF":1.6,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684520","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":"Reply from the author to \"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":"10.1177/03913988261461138","DOIUrl":"10.1177/03913988261461138","url":null,"abstract":"","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"509-510"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264432","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":"First clinical experience with citrate-anticoagulated CVVHD-based low-flow ECCO₂R in severe hypercapnic respiratory failure.","authors":"Frank W Kornitzky, Elena Pfeuffer-Jović, Jan Stumpner, Matthias Held","doi":"10.1177/03913988261455788","DOIUrl":"10.1177/03913988261455788","url":null,"abstract":"<p><strong>Background: </strong>Hypercapnic respiratory failure is a frequent and life-threatening condition in intensive care. While lung-protective ventilation is essential to limit ventilator-induced lung injury, it may aggravate hypercapnia, particularly in severely ill patients. Low-flow extracorporeal CO₂ removal (ECCO₂R) has therefore been proposed as an adjunct to facilitate CO₂ clearance and support protective ventilation. When integrated into continuous renal replacement therapy (CRRT) platforms, ECCO₂R offers a less invasive alternative to high-flow extracorporeal support. However, the effectiveness of CRRT-based ECCO₂R operated at very low blood flows, particularly under regional citrate anticoagulation, remains insufficiently characterized.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of invasively ventilated ICU patients with severe hypercapnic respiratory failure treated with low-flow ECCO₂R integrated into a citrate-anticoagulated CRRT system. Arterial blood gas parameters and ventilatory settings were retrospectively extracted at baseline and 2, 12, and 48 h after ECCO₂R initiation.</p><p><strong>Results: </strong>In 11 patients, median PaCO₂ decreased from 83.1 to 52.9 mmHg at 48 h, with a corresponding rise in pH from 7.21 to 7.33 (both <i>p</i> = 0.008). Tidal volume showed early pairwise changes, whereas overall ventilator settings and oxygenation remained unchanged. The system was feasible, required no systemic anticoagulation, and caused no coagulation-related complications.</p><p><strong>Conclusions: </strong>In invasively ventilated patients with severe hypercapnic respiratory failure, low-flow ECCO₂R integrated into citrate-anticoagulated CRRT reduced PaCO₂ and improved acidosis, without significant overall changes in ventilator settings. This first report of exclusive regional citrate anticoagulation in CRRT-based ECCO₂R demonstrated feasibility and safety without coagulation complications. Despite a blood-flow limit of 200 ml/min, a statistically significant and clinically detectable reduction in PaCO₂ was achieved.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"544-554"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375806","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":"Clinical and metabolic outcomes of artificial pancreas systems in patients with type 1 diabetes: A real-world study.","authors":"Rojda Kotan, Ensar Gazi Göçer, Bahri Evren","doi":"10.1177/03913988261456923","DOIUrl":"10.1177/03913988261456923","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial pancreas systems represent an important technological advancement in the management of type 1 diabetes mellitus (T1DM). These systems provide automated insulin delivery and have the potential to improve glycemic control and cardiometabolic outcomes. In this study, we aimed to evaluate the effects of artificial pancreas systems on glycemic control, lipid parameters, and proteinuria in patients with T1DM in a real-world clinical setting.</p><p><strong>Methods: </strong>This retrospective study included 32 patients with T1DM who transitioned to artificial pancreas therapy. Glycemic parameters including HbA1c, fasting blood glucose (FBG), and postprandial blood glucose (PBG) were compared before pump initiation and at 3 months, 6 months, and 1 year after treatment. Lipid parameters and spot urine proteinuria levels were evaluated before pump therapy and at 1-year follow-up. Repeated measures ANOVA and paired t-tests were used for continuous variables, while Cochran's Q and McNemar tests were used for categorical variables.</p><p><strong>Results: </strong>A significant reduction in HbA1c levels was observed over time, decreasing from 8.74 ± 1.21% before pump initiation to 7.92 ± 0.98% at 3 months, 7.61 ± 0.87% at 6 months, and 7.48 ± 0.83% at 1 year (<i>p</i> < 0.001). Fasting and postprandial glucose levels also significantly declined during follow-up (<i>p</i> < 0.001). LDL cholesterol and total cholesterol levels decreased significantly at 1 year (<i>p</i> = 0.029 and <i>p</i> = 0.006, respectively), while HDL cholesterol increased significantly (<i>p</i> = 0.022). The reduction in triglyceride levels was not statistically significant (<i>p</i> = 0.069). Proteinuria levels decreased from 84.6 ± 42.3 mg/g before pump therapy to 61.8 ± 35.7 mg/g at 1 year (<i>p</i> = 0.011). The proportion of patients achieving HbA1c target increased from 18.8% before pump therapy to 62.5% at 1 year (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Artificial pancreas therapy significantly improves glycemic control and increases the proportion of patients achieving HbA1c targets in individuals with T1DM. In addition, favorable effects on lipid profile and proteinuria suggest potential cardiometabolic benefits of artificial pancreas systems.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"568-571"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264490","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":"Spectral CT quantification of organ mass and physical density: A non-invasive metric for assessing functional reserve in type 2 diabetes.","authors":"Yishan Li, Ge Liu, Liangliang Shang, Rui Wang, Yanjun Gao","doi":"10.1177/03913988261452658","DOIUrl":"10.1177/03913988261452658","url":null,"abstract":"<p><strong>Introduction: </strong>Conventional imaging fails to quantify the true physical density and mass of organs. This study aims to develop a spectral CT-based physical modeling approach to quantify organ remodeling in type 2 diabetes mellitus (T2DM).</p><p><strong>Methods: </strong>A total of 97 subjects (46 T2DM patients and 51 non-diabetic controls) were evaluated. Organ regions (liver, pancreas, spleen) were automatically segmented using a V-Net neural network. A physical density model was constructed based on spectral parameters. We compared organ CT value, effective atomic number, mass, volume, and physical density between groups and analyzed their correlation with HbA1c levels.</p><p><strong>Results: </strong>The physical density model showed high accuracy, with measured subcutaneous fat density aligning with standard physical references. In T2DM patients, pancreatic mass and physical density decreased significantly. Conversely, liver and spleen mass increased without significant changes in physical density. Pancreatic physical density showed a significant negative correlation with HbA1c, with rho = -0.411 and <i>p</i> < 0.001.</p><p><strong>Discussion: </strong>The spectral physical density model provides a precise, non-invasive metric for assessing organ quality. The strong correlation between pancreatic density and glycemic supports its potential utility in evaluating functional reserve for artificial organ.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"536-543"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264454","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":"Evaluation of arteriovenous fistulas of obtuse anastomosis in reducing thrombosis using computational fluid dynamics.","authors":"Milad Rostami, Majid Abdolalinezhad, Mohsen Hashemi, Mohammad Amin Rahimi","doi":"10.1177/03913988261455782","DOIUrl":"10.1177/03913988261455782","url":null,"abstract":"<p><p>Arteriovenous fistula (AVF) failure in hemodialysis patients is strongly influenced by local hemodynamic factors such as elevated wall shear stress, flow separation, and vortex formation. In this study, computational fluid dynamics (CFD) simulations are performed to investigate the influence of anastomosis angle and blood rheology on AVF hemodynamics. Three non-Newtonian blood models (Carreau, power-law, and Casson) are first evaluated at 45°, 90°, and 135° anastomosis angles and validated against available experimental data. Based on shear stress prediction accuracy, the Carreau model is demonstrated as the best agreement and is selected for further simulations. Subsequently, AVFs with 45°, 90°, 110°, 120°, 135°, 145°, and 160° anastomosis angles are analyzed under maximum, medium, and minimum pulsatile flow conditions. Hemodynamic parameters including velocity patterns, wall shear stress distribution, vortex formation, and pressure drop between the proximal artery and vein are evaluated. Results indicate that increasing the anastomosis angle significantly reduces maximum wall shear stress, high-shear regions, vortex intensity, and pressure drop. Compared with the 45° configuration, the 160° angle reduced maximum shear stress by ~78% under peak flow conditions. Overall, obtuse anastomosis angles demonstrated improved hemodynamic performance, suggesting that larger angles may reduce thrombosis risk and cardiovascular burden in hemodialysis patients. Considering both hemodynamic performance and surgical feasibility, the 120° configuration is proposed as a clinically practical and effective option.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"520-535"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345263","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":"Development of an early prediction model for ICU-acquired weakness in sepsis using PNI and SII.","authors":"Bing Sun, Changhua Jiang, Wanjun Jian","doi":"10.1177/03913988261456928","DOIUrl":"10.1177/03913988261456928","url":null,"abstract":"<p><strong>Objectives: </strong>ICU-AW is common among sepsis survivors. This study developed and validated an early prediction model for ICU-AW in septic patients and evaluated whether the Prognostic Nutritional Index (PNI) and systemic immune-inflammation index (SII), derived from routine admission blood tests, improve prediction beyond conventional clinical variables.</p><p><strong>Methods: </strong>This single-center retrospective cohort study enrolled adult sepsis patients with an ICU stay ⩾ 48 h and complete laboratory data within 24 h of admission. ICU-AW was diagnosed using a Medical Research Council (MRC) sum score < 48. Candidate predictors, including SOFA, were screened by LASSO regression and entered into multivariable logistic regression to build the model. An ablation model excluding PNI and SII was used to assess their incremental predictive value.</p><p><strong>Results: </strong>A total of 425 patients were included (training set: 297; validation set: 128), with an overall ICU-AW incidence of 40.8%. After adding SOFA to candidate predictors, the final model included APACHE II score, SOFA score, septic shock, endotracheal intubation, vasoactive agent use, DIC, PCT, and SII/100, whereas PNI/10 showed a non-significant protective trend. The full model achieved AUCs of 0.872 and 0.851 in the training and validation sets, respectively, versus 0.846 and 0.824 for the ablation model, with slightly better calibration and net benefit.</p><p><strong>Conclusion: </strong>The nomogram may help identify septic patients at high risk for ICU-AW within 24 h of ICU admission. SII appeared to improve prediction, whereas PNI contributed little and should be interpreted cautiously. These findings may support early risk stratification, but the added value of these biomarkers requires further validation.</p>","PeriodicalId":13932,"journal":{"name":"International Journal of Artificial Organs","volume":" ","pages":"555-567"},"PeriodicalIF":1.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375823","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}