{"title":"Acknowledgments to reviewers.","authors":"","doi":"10.1007/s10047-025-01527-6","DOIUrl":"https://doi.org/10.1007/s10047-025-01527-6","url":null,"abstract":"","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124677","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":"Use of shunt-side esCCO monitoring for hemodynamic management during hemodialysis as a novel approach for early detection of hypotension: a report of two cases.","authors":"Koji Nakai, Yuichi Hirate, Takeyuki Hiramatsu, Kazue Kojima, Yuika Wada, Takashi Nakajima, Aiko Nakai","doi":"10.1007/s10047-025-01526-7","DOIUrl":"https://doi.org/10.1007/s10047-025-01526-7","url":null,"abstract":"<p><p>Early recognition of the signs of hypotension may lead to prompt intervention by medical professionals, reducing the risk of intradialytic hypotension. The study included two patients on dialysis, one with stable hemodynamics (Case 1) and one who developed hypotensive shock (Case 2), in whom noninvasive continuous hemodynamic monitoring using shunt-side estimated continuous cardiac output (esCCO) was performed. Noninvasive blood pressure (BP), heart rate, esCCO, estimated stroke volume, systemic vascular resistance, and decrease in blood volume of each patient before and after dialysis were evaluated in chronological order. In Case 1, esCCO decreased transiently with the decrease in blood volume, but with the adaptive change in heart rate and estimated stroke volume, the BP remained stable at the end. In Case 2, there was a rapid decrease in esCCO after the systemic vascular resistance compensation reached its limit, and esCCO decreased 30 min before a decrease in noninvasive BP became evident. These results indicate that shunt-side esCCO monitoring may detect signs of hypotension that cannot be detected using conventional BP monitoring systems. Monitoring using shunt-side esCCO may be a prospective method for intradialytic hemodynamic management.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992609","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}
M Foltan, D Dinh, M Gruber, T Müller, C Hart, L Krenkel, C Schmid, K Lehle
{"title":"Incidence of neutrophil extracellular traps (NETs) in different membrane oxygenators: pilot in vitro experiments in commercially available coated membranes.","authors":"M Foltan, D Dinh, M Gruber, T Müller, C Hart, L Krenkel, C Schmid, K Lehle","doi":"10.1007/s10047-024-01486-4","DOIUrl":"10.1007/s10047-024-01486-4","url":null,"abstract":"<p><p>Neutrophil extracellular traps (NETs) were detected in blood samples and in cellular deposits of oxygenator membranes during extracorporeal membrane oxygenation (ECMO) therapy and may be responsible for thrombogenesis. The aim was to evaluate the effect of the base material of gas fiber (GF, polymethylpentene) and heat exchange (HE) membranes and different antithrombogenic coatings on isolated granulocytes from healthy volunteers under static culture conditions. Contact of granulocytes with membranes from different ECMO oxygenators (with different surface coatings) and uncoated-GFs allowed detection of adherent cells and NETotic nuclear structures (normal, swollen, ruptured) using nuclear staining. Flow cytometry was used to identify cell activation (CD11b/CD62L, oxidative burst) of non-adherent cells. Uncoated-GFs were used as a reference. Within 3 h, granulocytes adhered to the same extent on all surfaces. In contrast, the ratio of normal to NETotic cells was significantly higher for uncoated-GFs (56-83%) compared to all coated GFs (34-72%) (p < 0.001) with no difference between the coatings. After material contact, non-adherent cells remained vital with unchanged oxidative burst function and the proportion of activated cells remained low. The expression of activation markers was independent of the origin of the GF material. In conclusion, the polymethylpentene surfaces of the GFs already induce NET formation. Antithrombogenic coatings can already reduce the proportion of NETotic nuclei. However, it cannot be ruled out that NET formation can induce thrombotic events. Therefore, new surfaces or coatings are required for future ECMO systems and long-term implantable artificial lungs.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"374-382"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949352","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":"Differences between xenotransplantation and allogeneic kidney transplantation: the current situation and future challenges in Japan.","authors":"Soichi Matsumura, Yoichi Kakuta, Yoko Maegawa-Higa, Shota Fukae, Ryo Tanaka, Shigeaki Nakazawa, Kazuaki Yamanaka, Shuji Miyagawa, Norio Nonomura","doi":"10.1007/s10047-025-01506-x","DOIUrl":"10.1007/s10047-025-01506-x","url":null,"abstract":"<p><p>Kidney transplantation is the only curative option for patients with chronic renal failure, significantly improving their survival and quality of life. However, this treatment remains limited by the shortage of organ donors. The shortage of kidney donors remains a serious problem all over the world, and is particularly severe in Japan. While advancements in immunosuppressive therapies and histocompatibility testing have improved outcomes in allogeneic kidney transplantation, the rising number of dialysis patients has worsened the gap between the demand for and supply of suitable donor organs. In response to this pressing need, xenotransplantation has gained attention as a promising alternative solution. Recent progress driven by gene-editing technologies, including CRISPR-Cas9, has facilitated the development of genetically modified pigs suitable for potential human transplantation. This review provides an overview of the key differences in immune response and infection risks between xenogeneic and allogeneic kidney transplants. In addition, it comprehensively examines the challenges and potential of xenogeneic kidney transplantation from multiple perspectives, including differences in immunosuppressive therapies between allogeneic and xenogeneic transplantation. We also discuss the feasibility of xenogeneic kidney transplantation as a solution to the organ shortage in Japan and present directions for addressing challenges toward clinical application. We hope this review will provide valuable insights into the potential of xenogeneic kidney transplantation as a new treatment option for chronic renal failure and contribute to efforts to address the donor shortage problem in Japan.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"336-342"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025937","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":"Fouling process of hemodiafiltration membranes by hemodialysis and hemodiafiltration therapy.","authors":"Yoshihiro Tange, Masashi Kawakami, Shingo Takesawa","doi":"10.1007/s10047-025-01497-9","DOIUrl":"10.1007/s10047-025-01497-9","url":null,"abstract":"<p><p>During hemodialysis, proteins, such as albumin and globulin, are deposited on the dialysis membrane surface, causing fouling that affects solute removal and biocompatibility. This study aimed to measure the filtration coefficient as an index of dialysis membrane conditions in hemodialysis, pre-dilution online hemodiafiltration, and intermittent infusion hemodiafiltration modes using two different hemodiafiltration membranes ex vivo. The filtration coefficients of hemodiafiltration membranes in hemodialysis, pre-dilution online hemodiafiltration, and intermittent infusion hemodiafiltration modes were continuously measured for 123 min using 2 L bovine blood, which was adjusted with 32% hematocrit and 6.5 g/dL of total proteins. Polysulfone and cellulose triacetate were used as test membrane materials, and both membrane structures were asymmetric. The first fouling step was observed 20 s after filtration of both polysulfone and cellulose triacetate membranes in each mode. Thereafter, the filtration coefficient recovered in the pre-dilution online hemodiafiltration mode. However, it plateaued in the cellulose triacetate membrane and decreased in the polysulfone membrane. A flushing effect of the intermittent infusion hemodiafiltration mode was observed in both the cellulose triacetate and polysulfone membranes. The differences in fouling steps in each of the three modes-hemodialysis, pre-dilution online hemodiafiltration, and intermittent infusion hemodiafiltration-can be identified by continuously measuring filtration coefficient values.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"408-414"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523436","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":"Silk-elastin sponge is effective for burn therapy after surgical debridement.","authors":"Yoshitaka Matsuura, Katsuya Kawai, Shingo Kawabata, Kazuo Noda, Eiichi Sawaragi, Naoki Morimoto","doi":"10.1007/s10047-025-01496-w","DOIUrl":"10.1007/s10047-025-01496-w","url":null,"abstract":"<p><p>Silk-elastin is an artificial protein that helps promote wound healing. The present study was performed to examine the effect of silk-elastin on burns using an animal model. Partial- and full-thickness burns were applied to the back of rats using a metal device. And the necrotic tissue was excised via surgical debridement and dressing materials were applied. Two groups, namely, the silk-elastin sponge and control groups, were established in the case of deep partial-thickness burns and full-thickness burns, respectively. Tissue samples from the partial-thickness burn model obtained at the 5th day and the 7th day after debridement were analyzed. The length of epithelization in the tissue sample and wound healing rate were evaluated on macro-photographs. And tissue samples from the full-thickness burn model obtained at the 7th day and 14th day after debridement were analyzed. The area of granulation, length of epithelization, and number of vessels in the tissue sample and wound healing rate were evaluated on macro-photographs. The silk-elastin group showed a better wound healing rate and superior epithelization and granulation and angiogenesis in comparison to control group. And our findings on day 14 in full-thickness burn suggest a potential difference in the quality of scars. Silk-elastin sponge can help promote burn wound healing after debridement. This new material can accelerate epithelization, granulation, and neoangiogenesis at the early stage after application with less dressing change. We believe that silk-elastin is a good material for use in topical burn therapy. And the new material may reduce scar forming after healed.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"439-448"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523437","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 novel blood volume monitoring approach in a venous reservoir using a laser displacement sensor for blood surface distance measurement.","authors":"Shinichi Fukuhara, Ken-Ichiro Yamamoto","doi":"10.1007/s10047-025-01505-y","DOIUrl":"10.1007/s10047-025-01505-y","url":null,"abstract":"<p><p>A venous reservoir (VR) is crucial for safe blood volume regulation during cardiopulmonary bypass (CPB) procedures. Currently, blood volume measurement in VRs relies heavily on visual inspection, which limits its accuracy and responsiveness. In this paper, a method that leverages a laser displacement sensor for blood surface distance change detection in VRs with high accuracy and simplicity is proposed. It enables precise, non-contact, real-time measurements for displacement and position analysis of blood surface. Hard-shell VRs maintain a constant relationship between blood volume and blood surface height. Therefore, we measured the blood surface distance and the distance between the sensors. The findings of this study demonstrate that blood volume correlates with the distance measured from the blood surface to the sensor, showing clear \"blood surface distance-volume characteristic\" curves specific to each VR. Experimental results confirm excellent reproducibility and low variability, even under different conditions, such as blood dilution and varying ambient light. In addition, the blood volume dynamic behavior during CPB can be captured with measurements that are in good agreement with theoretical predictions. Our findings confirm the potential of blood volume estimation based on blood surface distance measurements, making it a promising alternative for real-time blood volume monitoring during CPB. Integrating this method into CPB systems could improve safety, prevent air embolisms, and improve fluid management, paving the way for more precise and automated circulating blood volume control.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"365-373"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078273","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 first case of central Y-Y extra-corporeal membrane oxygenation system in a pediatric patient.","authors":"Kazuki Tanimoto, Shigemitsu Iwai, Motoki Komori, Naoki Tadokoro, Satsuki Fukushima, Hajime Ichikawa","doi":"10.1007/s10047-024-01490-8","DOIUrl":"10.1007/s10047-024-01490-8","url":null,"abstract":"<p><p>The mechanical circulatory support (MCS) for pediatric patients with severe acute heart failure and poor pulmonary conditions is challenging. Herein, we report the first pediatric case of successfully treated by central Y-Y extra-corporeal membrane oxygenation (ECMO). A 10-year-old boy weighing 35 kg with a body surface area of 1.11 m<sup>2</sup> was transferred to our institution in cardiac arrest with ongoing cardiopulmonary resuscitation using intra-aortic balloon pump and peripheral ECMO inserted at the previous hospital. Then, MCS system was converted to central ECMO with left heart drainage due to severe pulmonary congestion and the anticipation of long-term MCS. After 3 days, we converted it to central Y-Y ECMO because of concern about intracavitary thrombus formation due to poor pulmonary conditions. After four more days, the pulmonary conditions were improved, and we converted the MCS system into left ventricular assist device (LVAD) system. He is awaiting the heart transplantation eligibility review in a stable condition. Central Y-Y ECMO system can be used as a bridge to decision also for a pediatric patient with acute severe heart failure and poor pulmonary conditions.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"468-472"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433230","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":"Why is organ transplantation from cardiac death donors necessary in Japan? An important strategy for heart transplantation in severe donor shortage.","authors":"Hikaru Matsuda","doi":"10.1007/s10047-025-01493-z","DOIUrl":"10.1007/s10047-025-01493-z","url":null,"abstract":"<p><p>Brain-dead donor (DBD) is the basis for most organ transplants and has been the exclusive method of choice for heart transplantation (HTx). However, the severe shortage of donors has been the common problem worldwide, especially in Japan. Meanwhile, the number of donors after cardiac (circulatory) death (DCD) has increased rapidly in the last 10 years, especially in Europe, thus expanding the donor pool. This strategy has been introduced in HTx since 2014, starting in Australia and the United Kingdom, with acceptable results. In most DCD, organs are removed under withdrawal of life support (WLST), which is called controlled DCD (cDCD). In Japan, we should consider introducing cDCD to supplement DBD, which is compromised by the shortage of donors. In this setting of cDCD, ethical and regulatory arguments arise as to the definition of human death and how to deal with WLST in organ donation. From a regulatory point of view, cDCD has been misunderstood as requiring a separate legislative development, and to dispel this misconception is the important message of this report. The development of an ex vivo machine perfusion system is another issue to start cDCD HTx as well as other organs. This paper outlines the issues involved in the introduction of cDCD for heart transplantation in Japan.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"288-292"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407749","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 hybrid thoracic endovascular aortic repair for aortic arch diseases on life expectancy.","authors":"Tomoaki Kudo, Toru Kuratani, Ryoto Sakaniwa, Yoshiki Sawa, Shigeru Miyagawa","doi":"10.1007/s10047-025-01503-0","DOIUrl":"10.1007/s10047-025-01503-0","url":null,"abstract":"<p><p>This study aimed to investigate whether the efficacy of proximal landing zones (LZs) 0, 1, and 2 in hybrid thoracic endovascular aortic repair (TEVAR) without cardiopulmonary bypass (CPB) in elderly patients can broaden aortic arch surgical eligibility from the perspective of a lifetime loss. From April 2008 to March 2020, 254 patients who underwent LZs 0, 1, and 2 hybrid TEVAR without CPB were enrolled (zone 0 in 41, zone 1 in 82, and zone 2 in 131 patients). The patients had a median age of 73 years, with a median follow-up period of 5.8 years. The median operative time was 172 min, the median postoperative hospital stay was 11 days, and the discharge rate to home was 95.3%. The survival rate, aorta-related death-free rate, and aortic events-free rate at 10 years were 72.8%, 97.0%, and 88.5%. A multivariable Cox proportional hazard regression analysis showed that age (p < 0.001), preoperative stroke (p = 0.042), and an occurrence of 30-day aortic events (p = 0.022) were significant risk factors for all-cause death. The lifetime loss for 75, 80, 85, and ≥ 90-year-old patients at the time of surgery was 0.2, 0.1, 0, and 0 years. Despite the high risk of surgical management of aortic arch diseases, this study revealed that LZs 0, 1, and 2 hybrid TEVAR without CPB in ≥ 75-year-old patients can be expected to result in a life expectancy similar to the standard life expectancy. Advanced age alone should not exclude surgical treatment for patients with arch diseases.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"383-392"},"PeriodicalIF":1.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007538","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}