Journal of Artificial Organs最新文献

{"title":"Correction: Extracorporeal life support for severe heart failure in a diffuse panbronchiolitis patient awaiting lung transplant: a case report.","authors":"Yoshikazu Kimura, Shuji Okahara, Haruki Sunami, Shin Tanaka, Hisao Higo, Satoshi Suzuki, Kazuyoshi Shimizu","doi":"10.1007/s10047-026-01594-3","DOIUrl":"https://doi.org/10.1007/s10047-026-01594-3","url":null,"abstract":"","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206897","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":"Association between pre-processing total protein and processing time in drop-type cell-free and concentrated ascites reinfusion therapy.","authors":"Kazuha Sagiya, Naoki Ogasawara, Shinya Inahara, Ryota Takahashi, Tomoka Hayasaka, Yuya Shimizu, Ryo Chubachi, Masakazu Suzuki, Shunsuke Kawamoto","doi":"10.1007/s10047-026-01602-6","DOIUrl":"https://doi.org/10.1007/s10047-026-01602-6","url":null,"abstract":"<p><p>Predicting processing time in drop-type cell-free and concentrated ascites reinfusion therapy (CART) remains difficult. We examined whether pre-processing total protein (TP) was associated with processing time after accounting for ascites amount, processing height, ascites etiology, and repeated sessions. We retrospectively analyzed 97 CART sessions in 51 patients. Log-transformed processing time was analyzed using a linear mixed-effects model including pre-processing TP, pre-processing ascites amount, processing height (140 or 200 cm), and ascites etiology as fixed effects, with patient as a random intercept. Receiver operating characteristic (ROC) analysis of pre-processing TP for an above-preferred-range session-averaged processing rate (>2,000 mL/h) was secondary and exploratory. Higher pre-processing TP (β = 0.259, 95% confidence interval (CI) 0.194-0.325; P < 0.001), greater ascites amount per 1,000 g (β = 0.270, 95% CI 0.234-0.305; P < 0.001), and 140-cm versus 200-cm processing height (β = 0.161, 95% CI 0.038-0.284; P = 0.012) were associated with longer processing time, whereas ascites etiology was not significantly associated. The overall ROC cutoff was 1.2 g/dL (area under the curve (AUC), 0.931), and the first-session AUC was 0.947 (95% CI, 0.884-1.000). Higher pre-processing TP remained significantly associated with longer processing time after accounting for ascites amount, processing height, ascites etiology, and repeated sessions. Pre-processing TP may serve as a practical workflow-oriented indicator in drop-type CART, whereas ROC-derived cutoffs should be interpreted as exploratory.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206920","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":"Moderate therapeutic hypothermia with mechanical left ventricular unloading on non-infarct area in an acute myocardial infarction model.","authors":"Shusuke Imaoka, Masashi Kawamura, Akima Harada, Kei Ishikawa, Takashi Murakami, Akinobu Otani, Yudai Muratsuji, Hiroko Kudo, Yasuhiro Gan, Shunsuke Saito, Shigetaka Kusumoto, Masaki Takashina, Shigeru Miyagawa","doi":"10.1007/s10047-026-01593-4","DOIUrl":"https://doi.org/10.1007/s10047-026-01593-4","url":null,"abstract":"<p><p>Patients with cardiogenic shock due to acute myocardial infarction (AMI) treated with ECPELLA support have a poor prognosis. Impaired left ventricular (LV) wall motion is observed in both infarcted and non-infarcted areas. Therapeutic hypothermia and mechanical LV unloading have different myocardial protective effects. This study aimed to evaluate myocardial protective effects of moderate therapeutic hypothermia combined with mechanical LV unloading in non-infarcted areas using a porcine AMI model. The coronary artery was ligated, and an extracorporeal ventricular assist device was driven under mean left atrial pressure of 5 mmHg. Cooling was initiated via the thermostatic bath of ECMO 30 min after LAD ligation. Moderate therapeutic hypothermia (30-31 °C) was maintained for 2 h. The final evaluation was performed 30 min after rewarming. In the control group, LV fractional shortening (FS) and LV posterior wall motion score (WMS) were declined. In the hypothermia group, LVFS and LV posterior WMS were preserved. In the posterior wall of hypothermia group, mitochondria structure was maintained, reactive oxygen species production was reduced, and sarcoplasmic/endoplasmic reticulum Ca²⁺-ATPase expression was maintained more than in the control group. Moderate therapeutic hypothermia combined with mechanical LV unloading might provide more myocardial protection in non-infarcted areas compared to mechanical LV unloading alone in a porcine AMI model.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182199","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":"Successful management of long-term venovenous ECMO for severe PARDS in a child with acute lymphoblastic leukemia.","authors":"Hasan Özen, Gülçin Karaçoban, Fevzi Kahveci, Hasan Fatih Çakmaklı, Nazik Yener, Mehmet Ertem, Tanıl Kendirli","doi":"10.1007/s10047-026-01598-z","DOIUrl":"10.1007/s10047-026-01598-z","url":null,"abstract":"<p><p>Pediatric acute respiratory distress syndrome (PARDS) is an important cause of morbidity and mortality in pediatric intensive care units. We report successful prolonged venovenous extracorporeal membrane oxygenation (VV-ECMO) support in a child with severe PARDS and acute lymphoblastic leukemia (ALL). A 5-year-old boy with low-risk B-cell ALL developed severe refractory PARDS during induction therapy. VV-ECMO was initiated for profound hypoxemia and continued for 34 days, after which he was successfully decannulated. He was discharged after 235 days of hospitalization. This case suggests that prolonged VV-ECMO may be a feasible rescue strategy in carefully selected children with ALL when respiratory failure is potentially reversible and the oncological prognosis is favorable.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182125","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":"Impact of draining cannula position and configuration under high-flow extracorporeal CO₂ removal (ECCO₂R) on recirculation and extracorporeal decarboxylation.","authors":"Jonathan Charbit, Clara Muller, Mehdi Girard, Elie Courvalin, Geoffrey Dagod, Karim Bouchdoug, Pauline Deras, Hugues Weber, Xavier Capdevila","doi":"10.1007/s10047-026-01582-7","DOIUrl":"https://doi.org/10.1007/s10047-026-01582-7","url":null,"abstract":"<p><p>The main goal of the present study was to demonstrate the influence of draining cannulas' position and high-flow extracorporeal CO₂ removal (ECCO₂R) configuration on recirculation and extracorporeal decarboxylation. This single-center retrospective study was conducted between January 2018 and May 2024. All patients who received a high-flow ECCO₂R (extracorporeal blood flow ≥ 2 L/min) were included. Four configurations each used an ECMO device, two single-lumen cannulas, and an ipsilateral cannulation site: CENTRAL DRAINAGE configurations (central jugular-jugular and central femoro-femoral), DISTAL DRAINAGE configurations (distal jugular-jugular and distal femoro-femoral). Recirculation coefficient and CO₂ elimination were assessed between these configurations. The influence of the configuration and recirculation coefficient on CO₂ elimination was studied by multivariable mixed linear model. Eighteen patients were treated with high-flow ECCO₂R. Extracorporeal blood flows (median of 2.6 L/min [IQR, 2.0‒2.6 L/min]) were comparable between the configurations (P = 0.33), although values higher than 2.5 L/min were observed in CENTRAL DRAINAGE configurations. Median CO₂ elimination was 110 mL(STPD)/min (IQR, 83‒149 mL(STPD)/min). Recirculation coefficient was significantly higher with the DISTAL DRAINAGE configurations (59% [IQR, 51‒71%] versus 9% [IQR, 15‒22%], respectively; P < 0.001). Consequently, CO₂ elimination was significantly lower with the DISTAL DRAINAGE configurations (58 mL(STPD)/min [IQR, 44‒72 mL(STPD)/min] versus 122 mL(STPD)/min [IQR, 96‒159 mL(STPD)/min], respectively; P = 0.003). Both DISTAL DRAINAGE configurations and high recirculation coefficient were significantly associated in multivariable analysis with a reduction in CO₂ elimination (P < 0.001). We evaluated four different configurations of high-flow ECCO₂R using single-lumen cannulas allowing either a central or a distal drainage. A central drainage configuration gave better rheological conditions and lower recirculation, leading to better extracorporeal decarboxylation.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165849","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":"Axillary microaxial flow pump support for stepwise source control and bridge to durable left ventricular assist device therapy in cardiac device-related infective endocarditis.","authors":"Yohei Tamura, Shiro Nakahara, Masahito Saito, Kei Torikai, Koichi Toda, Isao Taguchi","doi":"10.1007/s10047-026-01599-y","DOIUrl":"10.1007/s10047-026-01599-y","url":null,"abstract":"<p><p>Cardiac device-related infective endocarditis complicated by end-stage heart failure poses a major therapeutic challenge because complete hardware removal is essential, whereas transvenous lead extraction may be poorly tolerated in patients with severe ventricular dysfunction and shock. We report a 53-year-old man with long-standing dilated cardiomyopathy and cardiac resynchronization therapy-defibrillator infection who presented with methicillin-sensitive Staphylococcus aureus bacteremia, pocket infection, respiratory failure, acute kidney injury, and a clinical presentation consistent with mixed septic-cardiogenic shock. Transthoracic echocardiography showed severe left ventricular dilatation and an ejection fraction of 10%. Because immediate extraction of a 17-year-old defibrillator lead was considered extremely high risk, an Impella 5.5 was implanted via the right subclavian artery, and surgical pocket drainage was performed as initial source control. After hemodynamic stabilization and reduction of vasoactive requirements, complete transvenous extraction of all leads was performed on hospital day 6 under ongoing Impella 5.5 support and cardiovascular surgical backup. During defibrillator lead traction, pulmonary artery pressure transiently decreased, but sustained systemic hemodynamic collapse did not occur. Following prolonged intravenous antibiotic therapy, blood cultures remained negative, renal function recovered sufficiently to discontinue continuous hemodiafiltration, and the patient was transferred to an advanced heart failure center. Durable left ventricular assist device implantation was subsequently performed successfully. This case suggests that axillary Impella 5.5 support may provide a stabilizing platform for staged source control, high-risk lead extraction, end-organ recovery, and bridge to durable mechanical circulatory support in carefully selected patients.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147984","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":"Pre-cannulation ventilation duration and the trajectory of venovenous extracorporeal membrane oxygenation in COVID-19-related acute respiratory distress syndrome: a nationwide competing-risks cohort study.","authors":"Takahiro Masuda, Akihiro Hirakawa","doi":"10.1007/s10047-026-01600-8","DOIUrl":"10.1007/s10047-026-01600-8","url":null,"abstract":"<p><strong>Purpose: </strong>Pre-cannulation ventilation duration is often considered in selecting candidates for venovenous extracorporeal membrane oxygenation, but its relationship with the subsequent support trajectory is uncertain. We examined associations with first liberation, death before liberation, and time on support.</p><p><strong>Methods: </strong>We analyzed a nationwide Japanese registry of patients receiving venovenous extracorporeal membrane oxygenation for COVID-19-related acute respiratory distress syndrome. First liberation and death before liberation were treated as competing transitions over 90 days. Cause-specific Cox models were stratified by epidemic period and adjusted for age, sex, and body mass index. Expected time on support was calculated from state-occupancy probabilities.</p><p><strong>Results: </strong>Among 1,420 patients, the adjusted hazard ratio for first liberation relative to 0-1 days was 0.87 (95% confidence interval 0.72-1.05) for 2-3 days, 0.65 (0.54-0.78) for 4-7 days, 0.41 (0.32-0.52) for 8-14 days, and 0.58 (0.34-0.98) for at least 15 days. The association was strongest during the first 14 days. Death before liberation, which does not represent overall mortality because follow-up after liberation was short, showed no monotonic gradient below 15 days. Expected time on support was 26.9 days after more than 7 days of ventilation and 18.4 days after 7 days or less.</p><p><strong>Conclusions: </strong>Among selected recipients, longer pre-cannulation ventilation, particularly 8-14 days, was associated with slower early liberation and longer support. It may inform the anticipated course and resource requirements after cannulation, but does not define a candidacy threshold.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136734","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":"Resolution of restless legs syndrome after postdilution online hemodiafiltration using a vitamin E-bonded polysulfone membrane: a report of two cases.","authors":"Masayuki Kimura, Naomi Morita, Kazuyoshi Karasuda, Kazuomi Yamashita, Toshiki Doi","doi":"10.1007/s10047-026-01596-1","DOIUrl":"10.1007/s10047-026-01596-1","url":null,"abstract":"<p><p>Two patients undergoing hemodialysis with long-standing, refractory restless legs syndrome were treated with pharmacologic therapy and high-efficiency online hemodiafiltration, achieving an α1-microglobulin removal rate of ≥ 40%. However, sufficient symptom improvement was not achieved. Therefore, online hemodiafiltration using a vitamin E-bonded polysulfone membrane, which has antioxidant effects, was introduced. Although only limited improvement was observed during predilution online hemodiafiltration, marked clinical benefit was obtained after switching to postdilution online hemodiafiltration. In both cases, the α1-microglobulin removal rates after initiation of postdilution online hemodiafiltration were below 40%. These findings suggest that high-efficiency α1-microglobulin removal and the use of a vitamin E-bonded polysulfone membrane may contribute to improvement in restless legs syndrome through distinct mechanisms. Additionally, the beneficial effect of a vitamin E-bonded polysulfone membrane may be affected by differences in the dilution mode during hemodiafiltration. This case report is the first to indicate that the use of a vitamin E-bonded polysulfone membrane during postdilution hemodiafiltration may represent a potential new therapeutic option for restless legs syndrome.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110145","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 cardiopulmonary resuscitation for cardiogenic shock in a Jehovah's witness.","authors":"Derek K Afflu, Louis F Chai, Hiromu Kehara, Sean M Baskin, Yoshiya Toyoda, Roh Yanagida","doi":"10.1007/s10047-026-01591-6","DOIUrl":"10.1007/s10047-026-01591-6","url":null,"abstract":"<p><p>Veno-arterial (V-A) and veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) are frequently employed in the management of cardiopulmonary failure in critically ill patients. Utilization, however, is controversial in the Jehovah's Witness (JW) population as temporary mechanical circulatory support (tMCS) typically is associated with blood loss requiring transfusions. Despite this fact, use of ECMO is still feasible in this population while avoiding blood transfusions and there have been few reported cases in the literature. However, its use as part of cardiopulmonary resuscitation is limited. Multiple strategies have been employed to limit blood loss and maximize endogenous hematopoiesis to assist in maintaining normal physiology while utilizing tMCS. Though these tactics are most useful when applied in the preintervention setting, they are applicable in the emergency setting including extracorporeal cardiopulmonary resuscitation (ECPR). This can be achieved with conscientious cannulation technique and circuit management. Presented here is a case report of the successful use of V-A ECMO in the resuscitation for a JW, avoiding blood product transfusions. The protocol utilized to eliminate the need for blood transfusions is also discussed. This approach adds to the growing body of evidence emphasizing that the use of tMCS as part of bloodless medicine practice is feasible, even in the emergency setting.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074948","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":"Impella purge solutions in patients receiving extracorporeal membrane oxygenation.","authors":"Nathaniel J Martin, Christoph G S Nabzdyk, Scott D Nei, Andrew N Rosenbaum, Troy G Seelhammer, Patrick M Wieruszewski","doi":"10.1007/s10047-026-01595-2","DOIUrl":"10.1007/s10047-026-01595-2","url":null,"abstract":"<p><p>The optimal Impella purge solution in patients receiving concomitant ECMO and Impella (ECPELLA) support remains to be elucidated. We aimed to assess Impella device function in patients supported by ECPELLA receiving heparin-containing or anticoagulant-free (5% dextrose or sodium bicarbonate) purge solutions. Of 25 included patients, 14 received anticoagulant-free and 11 received heparin-containing purge solutions, with a median of five days of ECPELLA support. The only episode of Impella device malfunction occurred in the heparin-containing group. Given the low event rate and apparent maintenance of acceptable device longevity, use of anticoagulant-free purge solutions alongside systemic anticoagulation in ECPELLA patients may be reasonable but requires validation in an appropriately powered study.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 4","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069635","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}