{"title":"Clinical outcomes of modified left ventricular assist device driveline management.","authors":"Shusuke Imaoka, Noriyuki Kashiyama, Daisuke Yoshioka, Shunsuke Saito, Takuji Kawamura, Ai Kawamura, Ryohei Matsuura, Yusuke Misumi, Koichi Toda, Shigeru Miyagawa","doi":"10.1007/s10047-024-01482-8","DOIUrl":"10.1007/s10047-024-01482-8","url":null,"abstract":"<p><p>Left ventricular assist devices (LVADs) are implanted in patients with heart failure to support cardiac circulation. However, no standardized methods have been established for LVAD driveline exit site management for the prevention of infections. Therefore, this study evaluated the efficacy of modified driveline management compared with that of conventional driveline management. We retrospectively assessed the outcomes of 262 patients who underwent continuous-flow LVAD implantation between January 2005 and March 2023 at Osaka University in Japan. In conventional driveline management, an LVAD driveline penetrates the skin along the body surface and is fixed near the penetration site (n = 224). In contrast, in our modified fixation method, the LVAD driveline vertically penetrates the skin to prevent ischemia at the driveline exit site and is fixed at a distant abdominal site to prevent the movement of the driveline exit site due to body movement (n = 38). The rates of freedom from LVAD driveline infection in patients with conventional driveline management were 86, 75, and 63% at 1, 2, and 3 years after LVAD implantation, respectively. The rate of freedom from LVAD driveline infection in patients managed by the modified fixation method was 91% at 1, 2, as well as 3 years after LVAD implantation. The freedom rates from LVAD driveline infection in the patients with modified fixation method was lower than in the patients with the conventional method (p = 0.04). Our study revealed that the modified fixation method may offer the possibility for preventing LVAD driveline infection.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"207-215"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854033","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":"Successful resuscitation from restart failure of left ventricular assist device in a patient with aortic valve closure.","authors":"Yuki Ichihara, Masashi Hattori, Yuki Echie, Satoshi Saito, Hiroshi Niinami","doi":"10.1007/s10047-025-01513-y","DOIUrl":"https://doi.org/10.1007/s10047-025-01513-y","url":null,"abstract":"<p><p>Once a pump stoppage of left ventricular assist device (LVAD) occurs, the hemodynamic status catastrophically collapses. Usage of an extracorporeal membrane oxygenation system (ECMO) can help organ perfusion, including in the brain; however, blood flow is regurgitated into the left ventricle through the outflow graft of LVAD, resulting in irreversible respiratory failure. This phenomenon might be further aggravated in LVAD patients with aortic valve closure because of no ejection flow through it at all. We experienced a case of successful resuscitation from restart failure of HeartWare LVAD pump during controller exchange in a patient with aortic valve closure. An 18Fr cannula was inserted into the lateral wall of the left ventricle as a vent prior to the outflow graft clamping. The patient was discharged with no neurological disorder. In addition to usual usage of peripheral ECMO system, as well as cardiopulmonary resuscitation, emergency left ventricle venting can contribute to recovery from fatal complication by reducing the abrupt increase of left ventricle pressure.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199232","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":"Veno-venous extracorporeal membrane oxygenation in managing acute respiratory distress syndrome associated with hemolytic uremic syndrome and septic shock: a case report.","authors":"Genta Kinoshita, Asami Ito-Masui, Takafumi Kato, Fumito Okuno, Kaoru Ikejiri, Ken Ishikura, Kei Suzuki","doi":"10.1007/s10047-024-01457-9","DOIUrl":"10.1007/s10047-024-01457-9","url":null,"abstract":"<p><p>Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a rescue therapy for severe respiratory failure in which conventional mechanical ventilation therapy is unsuccessful. Hemolysis during VV-ECMO support arises from multiple factors associated with organ damage and poor outcomes. Therefore, close and prompt monitoring is needed. Hemolytic uremic syndrome (HUS) is characterized by hemolysis, acute renal failure, and thrombocytopenia. Hemolytic features of the disease may complicate VV-ECMO management. A 26-year-old man with a history of cerebral palsy underwent VV-ECMO for acute respiratory distress syndrome (ARDS) due to septic shock caused by bacterial translocation during treatment for HUS. He showed features of hemolysis, with elevated lactate dehydrogenase (LDH), fragmented red blood cells, and low haptoglobin levels. Plasma free hemoglobin was measured daily throughout the whole course of ECMO with levels higher than 10 mg/dL but not exceeding 50 mg/dL. The extracorporeal membrane oxygenation (ECMO) circuit pressures were carefully monitored to ensure the pump generated no excessive negative pressure. The patient was weaned off ECMO on the eleventh day. There have been several cases of VA-ECMO in patients with HUS; however, there is limited literature on VV-ECMO. As the days on VV-ECMO tend to be longer than those on VA-ECMO, features of hemolysis may complicate management. Although HUS did not directly influence the clinical course in the present case, features of hemolysis were continuously observed. This case highlighted the importance of standard ECMO monitoring, especially daily measurement of plasma free hemoglobin.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"270-274"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446231","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":"Organs on chips: fundamentals, bioengineering and applications.","authors":"Nasser K Awad","doi":"10.1007/s10047-024-01460-0","DOIUrl":"10.1007/s10047-024-01460-0","url":null,"abstract":"<p><p>Human body constitutes unique biological system containing specific fluid mechanics and biomechanics. Traditional cell culture techniques of 2D and 3D do not recapitulate these specific natures of the human system. In addition, they lack the spatiotemporal conditions of representing the cells. Moreover, they do not enable the study of cell-cell interactions in multiple cell culture platforms. Therefore, establishing biological system of dynamic cell culture was of great interest. Organs on chips systems were fabricated proving their concept to mimic specific organs functions. Therefore, it paves the way for validating new drugs and establishes mechanisms of emerging diseases. It has played a key role in validating suitable vaccines for Coronavirus disease (COVID-19). Herein, the concept of organs on chips, fabrication methodology and their applications are discussed.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"110-130"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971152","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":"Skin substitutes: from conventional to 3D bioprinting.","authors":"C Deepa, Anugya Bhatt","doi":"10.1007/s10047-024-01481-9","DOIUrl":"10.1007/s10047-024-01481-9","url":null,"abstract":"<p><p>Three-dimensional bioprinting is getting enormous attention among the scientific community for its application in complex regenerative tissue engineering applications. One of the focus areas of 3-D bioprinting is Skin tissue engineering. Skin is the largest external organ and also the outer protective layer is prone to injuries due to accidents, burns, pathologic diseases like diabetes, and immobilization of patients due to other health conditions, etc. The demand for skin tissue and the need for an off-the-shelf skin construct to treat patients is increasing on an alarming basis. Conventional approaches like skin grafting increase morbidity. Other approaches include acellular grafts, where integration with the host tissue is a major concern. The emerging technology of the future is 3D bioprinting, where different biopolymers or hybrid polymers together provide the properties of extracellular matrix (ECM) and tissue microenvironment needed for cellular growth and proliferation. This raises the hope for the possibility of a shelf skin construct, which can be used on demand or even skin can be printed directly on the wound site (in-situ printing) based on the depth and complex structure of the wound site. In the present review article, we have tried to provide an overview of Skin tissue engineering, Conventional advancement in technology, 3D bioprinting and bioprinters for skin 3D printing, different biomaterials for skin 3D bioprinting applications, desirable properties of biomaterials and future challenges.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"154-170"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909694","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}
Karthikeyan Subbiahanadar Chelladurai, Jackson Durairaj Selvan Christyraj, Kamarajan Rajagopalan, Kayalvizhi Vadivelu, Meikandan Chandrasekar, Puja Das, Kalishwaralal Kalimuthu, Nivedha Balamurugan, Vijayalakshmi Subramanian, Johnson Retnaraj Samuel Selvan Christyraj
{"title":"Ex vivo functional whole organ in biomedical research: a review.","authors":"Karthikeyan Subbiahanadar Chelladurai, Jackson Durairaj Selvan Christyraj, Kamarajan Rajagopalan, Kayalvizhi Vadivelu, Meikandan Chandrasekar, Puja Das, Kalishwaralal Kalimuthu, Nivedha Balamurugan, Vijayalakshmi Subramanian, Johnson Retnaraj Samuel Selvan Christyraj","doi":"10.1007/s10047-024-01478-4","DOIUrl":"10.1007/s10047-024-01478-4","url":null,"abstract":"<p><p>Model systems are critical in biomedical and preclinical research. Animal and in vitro models serve an important role in our current understanding of human physiology, disease pathophysiology, and therapy development. However, if the system is between cell culture and animal models, it may be able to overcome the knowledge gap that exists in the current system. Studies employing ex vivo organs as models have not been thoroughly investigated. Though the integration of other organs and systems has an impact on many biological mechanisms and disorders, it can add a new dimension to modeling and aid in the identification of new possible therapeutic targets. Here, we have discussed why the ex vivo organ model is desirable and the importance of the inclusion of organs from diverse species, described its historical aspects, studied organs as models in scientific research, and its ex vivo stability. We also discussed, how an ex vivo organ model might help researchers better understand organ physiology, as well as organ-specific diseases and therapeutic targets. We emphasized how this ex vivo organ dynamics will be more competent than existing models, as well as what tissues or organs would have potentially viable longevity for ex vivo modeling including human tissues, organs, and/or at least biopsies and its possible advantage in clinical medicine including organ transplantation procedure and precision medicine.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"131-145"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728924","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":"Advanced roll porous scaffold 3D bioprinting technology.","authors":"Vyacheslav Shulunov","doi":"10.1007/s10047-024-01470-y","DOIUrl":"10.1007/s10047-024-01470-y","url":null,"abstract":"<p><p>Improvements in the roll porous scaffold (RPS) 3D bioproduction technology will increase print density of 10-15 µm cells by ~ 20% up to ~ 1.5 × 10<sup>8</sup> cells/mL and purity of organoid formation by > 17%. The use of 360 and 1200 dpi inkjet printheads immediately enables biomanufacturing with 10-30 µm cells in a single organoid with performance > 1.8 L/h for 15 µm layer thickness. The spongy bioresorbable ribbon for RPS technology is designed to solve the problems of precise placement, leakage and increasing in the number of instantly useable cell types and superior to all currently dominant 3D bioprinting methods in speed, volume, and print density without the use of expensive equipment and components. The potential of RPS for parallel testing of new substances studied was not on animals, but using generated 3D biomodels \"organ on a chip\". Solid organoids are more suitable for personalized medicine with simultaneous checking of several treatment methods and drugs, targeted therapy for a specific patient in vitro using the 3D composition of his personal cells, and selection of the most effective ones with the least toxicity. Overcoming the shortage of organs for implantation and personal hormone replacement therapy for everyone was achieved using printed endocrine glands based on their DNA.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"225-233"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142347289","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}
Weronika Koziak, Stanisław Dudek, Zbigniew Putowski, Filippo Sanfilippo, Mateusz Zawadka
{"title":"Exploring the role of plasmapheresis prior to thyroidectomy in managing thyrotoxicosis: a comprehensive scoping review.","authors":"Weronika Koziak, Stanisław Dudek, Zbigniew Putowski, Filippo Sanfilippo, Mateusz Zawadka","doi":"10.1007/s10047-024-01476-6","DOIUrl":"10.1007/s10047-024-01476-6","url":null,"abstract":"<p><p>A thyroid storm is the most extreme and life-threatening presentation of thyrotoxicosis. Thyroidectomy can be used for definitive treatment. It should be performed after euthyroidism is accomplished. The use of therapeutic plasma exchange (TPE) is a last resort option in cases where standard pharmacological therapy proves to be ineffective. Due to its rare prevalence, there are limited data evaluating the usefulness and efficacy of TPE as a bridging therapy to thyroidectomy. The absence of relevant literature prompted us to conduct a scoping review. The following bibliographic databases were searched for articles dated 30 November 2023: Medline, EMBASE, Web of Science and Google Scholar. The search identified 1047 records, of which 42 articles were accepted with a total of 234 patients. The dominant indications for TPE were side effects due to conventional treatment. The mean fT4 level decreased 51.9% of baseline after TPE, while the mean fT3 level decreased 66.6% of baseline. The main side effects observed with FFP were allergic reactions, while the use of an albumin solution was associated with perioperative bleeding. Based on the limited data available in the literature, we recognize plasmapheresis as an effective treatment option for reducing thyroid hormone levels prior to thyroidectomy in patients with thyrotoxicosis. Available data suggest that it might be reasonable to limit the number of sessions in favor of an earlier surgical intervention. To reduce the risk of bleeding, FFP may be a better option as a replacement fluid, especially in the session prior to thyroidectomy.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"146-153"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142400375","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":"Relation between antithrombin-III activity and activated clotting time for cardiopulmonary bypass.","authors":"Tomoaki Yamashiro, Yoshiyuki Takami, Yasushi Takagi","doi":"10.1007/s10047-024-01462-y","DOIUrl":"10.1007/s10047-024-01462-y","url":null,"abstract":"<p><p>Heparin resistance (HR) is observed before cardiopulmonary bypass (CPB), despite with normal antithrombin III (AT-III) levels. The relationships between preoperative AT-III activity and activated clotting time (ACT) after the first heparin dose should be clarified. We retrospectively analyzed the data of 818 patients who underwent CPB surgery, with the initial heparin of 300, 400, and 500 IU/kg, between 2017 and 2021. We defined HR as the failure to achieve ACT after the initial heparin dose (Post ACT) of > 480 s.There were no significant correlations between the AT-III activity and Post ACT in all patients, including 143 patients with AT-III activity < 80% and 675 patients with AT-III activity of ≥ 80%. Also, there were no significant correlations between the AT-III activity and Post ACT in 74 patients who received heparin of 300 IU/kg, in 186 patients with 400 IU/kg, and in 339 patients with 500 IU/kg. After identifying smoking, HR, activated partial thromboplastin time, fibrinogen degradation products (FDP), and ACT as influencing factors, multiple comparisons using the Steel-Dwass test showed significant difference in FDP and HR among the patients who received heparin of 300 IU/kg, 400 IU/kg, and 500 IU/kg. There is no association between preoperative AT-III activity and ACT after the first heparin administration for CPB, even in different dose of heparin. Rather, the higher the initial UFH dose is, the higher ACT may be, regardless of the AT-III activity.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"216-224"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878750","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":"Durable left ventricular assist devices in pediatrics: impact of body size on outcomes and size limitations.","authors":"Mimi Xiaoming Deng, Nao Yoshida, Christoph Haller, Aamir Jeewa, Shi-Joon Yoo, Osami Honjo","doi":"10.1007/s10047-024-01467-7","DOIUrl":"10.1007/s10047-024-01467-7","url":null,"abstract":"<p><p>Despite the range of body sizes in children, few ventricular assist devices (VAD) exist to support pediatric patients with end-stage heart failure. Large registry data identified weight < 20 kg to be associated with higher rates of VAD-related stroke, compared to > 40 kg. Moreover, patients < 1 years of age experience the highest post-implant mortality, with 1-year survival improving in an age-dependent manner. Within different VAD types, intracorporeal continuous (IC) devices confer the greatest clinical benefit and quality of life compared to paracorporeal alternatives. The major limitation of IC VADs is the technical challenge of implantation into patients of small body size, thus the majority of patients with IC devices are pre-adolescents or older. However, since 2021, the use of HeartMate 3™ (HM3) has expanded to patients as small as 17.7 kg. Although HM3 offers equally favorable survival outcomes irrespective of body size, patients of low body surface area are more likely to experience non-device-related major infections and renal dysfunction, with suggestion for elevated risk of major bleeding and stroke. Innovative imaging strategies have emerged to assess the feasibility of HM3 implantation and facilitate preoperative planning in small children. Moreover, the unmet need for an IC device in the infant population has revived interest in the axial pump, with a pivotal clinical trial currently underway. VAD outcomes in the pediatric population are not equivalent across all ages and body sizes, thus size-stratified analyses and device development to serve the full spectrum of body habitus are key considerations as this field rapidly evolves.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"171-176"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140199","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}