Journal of Artificial Organs最新文献

{"title":"Heart transplantation following a successful bridge-to-bridge strategy in acute type A aortic dissection with left main coronary malperfusion.","authors":"Tomoki Ushijima, Tobuhiro Nita, Takeo Fujino, Hiromichi Sonoda, Satoshi Kimura, Tatsushi Onzuka, Kunihiko Joo, Yusuke Ando, Shogo Matsunaga, Sho Matsuyama, Hirofumi Onitsuka, Kohtaro Abe, Akira Shiose","doi":"10.1007/s10047-026-01548-9","DOIUrl":"10.1007/s10047-026-01548-9","url":null,"abstract":"<p><p>A 55-year-old woman developed Stanford type A acute aortic dissection complicated by occlusion of the left main coronary artery. The patient underwent an emergency ascending aortic replacement with concomitant coronary artery bypass grafting to the left anterior descending artery. Owing to extensive myocardial ischemia and the resultant severe cardiopulmonary impairment, the patient could not be weaned from the cardiopulmonary bypass. Therefore, central veno-arterial extracorporeal membrane oxygenation was initiated, with aortic perfusion via a branch of the ascending aortic graft and right atrial drainage. The central veno-arterial extracorporeal membrane oxygenation system was subsequently converted to a paracorporeal left ventricular assist device with an oxygenator, following which respiratory support was no longer required. The patient was listed for heart transplantation and underwent an elective conversion to a durable left ventricular assist device as a bridge-to-bridge strategy. During this operation, relocation of the outflow graft was necessary, and aortic valvuloplasty was performed simultaneously to address the mild residual post-dissection aortic insufficiency. Ultimately, the patient underwent heart transplantation more than 4 years after the bridge-to-bridge operation. An effective sequential mechanical circulatory support strategy, combined with meticulous technical management during bridge-to-bridge surgery, can successfully facilitate bridging to heart transplantation.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372661","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":"Lipoprotein(a) and mechanical prosthetic valve thrombosis.","authors":"Fidel Manuel Caceres-Loriga, Humberto Morais","doi":"10.1007/s10047-026-01551-0","DOIUrl":"10.1007/s10047-026-01551-0","url":null,"abstract":"","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147365329","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":"Hemodynamic analysis of the aortic root based on differences in outflow graft angle in patients with implantable left ventricular assist devices.","authors":"Hiroaki Yamamoto, Hiroki Kohno, Hiroki Ikeuchi, Tomoyoshi Kanda, Michiko Watanabe, Tomohiko Inui, Kaoru Matsuura, Goro Matsumiya","doi":"10.1007/s10047-026-01547-w","DOIUrl":"10.1007/s10047-026-01547-w","url":null,"abstract":"<p><p>Aortic insufficiency (AI) that develops during long-term support with continuous-flow left ventricular assist devices (LVADs) remains a significant clinical problem. Abnormal flow patterns and altered wall shear stress (WSS) on the aortic valve are believed to contribute to leaflet remodeling, yet the hemodynamic influence of outflow graft orientation in patient-specific anatomies is not fully understood. This study investigated how different outflow graft angles affect aortic valve WSS and coronary perfusion using computational fluid dynamics (CFD). Three LVAD recipients who underwent preoperative ECG-gated coronary CT were retrospectively analyzed. Patient-specific geometries of the ascending aorta, aortic root, and coronary arteries were reconstructed. A cylindrical outflow graft was virtually anastomosed 25 mm above the sino-tubular junction, and three inclination angles (30°, 60°, 90°) were modeled with a fixed azimuthal angle of 90°. CFD simulations were performed under constant LVAD inflow (5.0 L/min) and uniform outlet pressure conditions. WSS on the aortic valve cusps and coronary flow rates were evaluated after achieving quasi-steady flow. Increasing outflow graft angle resulted in higher WSS on the ascending aortic wall opposite the anastomosis and consistently elevated WSS on the left coronary cusp. In some cases, the non-coronary cusp also showed localized WSS increases. Coronary flow decreased with shallower graft angles, with left coronary artery flow approximately halved at 30° compared with 90°, while right coronary flow exhibited a smaller reduction. Outflow graft angle substantially affects aortic valve WSS distribution and coronary perfusion. Steeper angles increase leaflet WSS, whereas shallower angles reduce coronary flow. Patient-specific CFD simulations may aid in optimizing graft positioning and reducing the risk of AI progression in LVAD patients.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 2","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344323","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":"Numerical optimization for selecting the optimal geometrical configuration of polymeric skin mesh.","authors":"Mehdi Khayami, Aisa Rassoli","doi":"10.1007/s10047-026-01549-8","DOIUrl":"10.1007/s10047-026-01549-8","url":null,"abstract":"<p><p>Burn injuries pose a critical healthcare challenge, particularly third-degree burns, which often result in extensive tissue damage and high mortality rates worldwide. Effective treatment typically involves skin grafting, with mesh grafts enabling coverage of larger wound areas using limited donor skin. Although various mesh designs have been developed, the optimal geometric configuration to minimize mechanical stress remains under investigation. This study evaluates the mechanical efficiency of three distinct mesh patterns applied to silicone-based skin models, aiming to reduce average stress and determine the optimal Young’s modulus. Finite element analysis was conducted using ABAQUS, and a genetic algorithm implemented in Python was employed to identify the best-performing mesh configuration. Among the tested geometries, a rectangular mesh measuring 3.975 mm × 1.157 mm (arranged in a 3-row, 13-column layout) produced the lowest average stress (0.045 MPa) and a corresponding Young’s modulus of 0.174 MPa. These findings provide a computational foundation for refining skin mesh designs, with potential applications in creating mechanically favorable conditions for skin graft expansion in severe burn management.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283818","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":"Case-specific optimal extracorporeal membrane oxygenation configuration for cardiogenic shock in the peripartum period: a case report.","authors":"Hideki Yoshida, Yoko Nishimura, Manami Suzuki, Koichi Hayashi, Toru Yoshida, Mumon Takita, Daiki Morikawa, Shuichi Fujii, Takeshi Kawaguchi, Naoki Shimizu, Isamu Hokuto, Nao Suzuki, Shigeki Fujitani","doi":"10.1007/s10047-026-01546-x","DOIUrl":"10.1007/s10047-026-01546-x","url":null,"abstract":"<p><p>For pregnant patients with severe coronavirus disease 2019 (COVID-19) requiring veno-venous (V-V) extracorporeal membrane oxygenation (ECMO), the ideal timing of delivery is uncertain, particularly when complicated by cardiogenic shock. A 44-year-old patient experienced severe respiratory failure due to COVID-19 at 23 weeks of gestation and underwent V-V ECMO support. Due to severely depressed biventricular cardiac function caused by Staphylococcus aureus bacteremia, the ECMO mode was converted from V-V to veno-arteriovenous (V-AV) ECMO, resulting in improved maternal cardiac function and fetal oxygen supply. At 27 weeks of gestation, she had an unexpected premature rupture of membranes and precipitous vaginal delivery. Despite several complications, she was successfully rehabilitated and discharged after 104 days of ECMO support. Appropriate ECMO implementation, including mode application, together with meticulous multidiscipline discussion on the optimal timing of delivery and prompt decision-making in the event of an unexpected delivery, is critical for maternal and fetal health.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"19"},"PeriodicalIF":1.2,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146132171","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":"Vascularization and maturation of kidney organoids: a comprehensive review of technological trends and challenges.","authors":"Yusuke Nishimura","doi":"10.1007/s10047-026-01545-y","DOIUrl":"10.1007/s10047-026-01545-y","url":null,"abstract":"<p><p>Chronic kidney disease is a global health issue, and novel therapeutic alternatives to dialysis and kidney transplantation must be developed. Human-induced pluripotent stem cell-derived kidney organoids recapitulate developmental processes and mimic kidney-like structures in vitro and have thus attracted attention for treating chronic kidney disease. However, the limited vascularization and immaturity of human-induced pluripotent stem cell-derived kidney organoids remain major barriers to their clinical application. The latest technological advances and specific challenges in kidney organoid vascularization and maturation were thoroughly examined in this review. Diverse approaches were considered, including coculturing with endothelial cells, in vivo transplantation, applying biomaterials and microfluidic systems, controlling molecular signaling, and metabolic reprogramming. However, issues persist such as low reproducibility, lack of standardization, insufficient functional evaluations, and inadequate safety assessments. Future studies should focus on developing multifactorial and strategies for integrating multiple cell types, establishing maturation assessment criteria, and verifying the long-term functionality and safety of three-dimensional bioprinting technologies. Technologies for the vascularization and maturation of kidney organoids show promise as foundational methods for use innovative regenerative medicine and the development of drug discovery therapies.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"18"},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125227","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":"Resolution of intradialytic hypotension and changes in hepatic oxygenation following the transition from hemodialysis to intermittent infusion hemodiafiltration: a case report.","authors":"Haruhisa Miyazawa, Kiyonori Ito, Yusaku Watanabe, Wataru Okamoto, Moeka Suzuki, Junki Morino, Yuko Mutsuyoshi, Taisuke Kitano, Jo Yoshizawa, Mamoru Yoshizawa, Susumu Ookawara","doi":"10.1007/s10047-025-01544-5","DOIUrl":"10.1007/s10047-025-01544-5","url":null,"abstract":"<p><p>An 82-year-old Japanese man had been undergoing hemodialysis (HD) for the preceding 5 months for chronic glomerulonephritis. During HD, the patient experienced recurrent episodes of intradialytic hypotension (IDH) resulting from an ultrafiltration-induced reduction in blood volume. Although we recommended an increase in dry weight to mitigate the onset of IDH, the patient declined this proposal. To maintain systemic hemodynamic stability during dialysis, the treatment modality was changed from HD to intermittent infusion hemodiafiltration (I-HDF). Relative changes in blood volume (%ΔBV) and hepatic regional oxygen saturation (rSO2) during both HD and I-HDF were continuously monitored using a Blood Volume Monitoring System (NIPRO Co., Osaka, Japan) and an INVOS 5100c oxygen saturation monitor (Covidien Japan, Tokyo, Japan), respectively. The decline in %ΔBV at the end of I-HDF was less pronounced than during HD (HD − 16.9%; I-HDF − 12.8%), and hepatic rSO2 remained stable during I-HDF, in contrast to the continuous decrease observed during HD. Moreover, no episode of IDH was observed in the I-HDF. Improved systemic hemodynamic stability observed during I-HDF may be attributable to the preservation of hepato-splanchnic circulation and oxygenation associated with cyclic dialysate infusion, although direct evidence for this association is still lacking.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"17"},"PeriodicalIF":1.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010366","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":"Heart-gut interaction in veno-arterial extracorporeal membrane oxygenation: a forgotten axis in critical care perfusion.","authors":"Amr Omar","doi":"10.1007/s10047-025-01543-6","DOIUrl":"10.1007/s10047-025-01543-6","url":null,"abstract":"<p><p>The expanding use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock and post-cardiotomy support necessitates a focus on perfusion beyond traditional targets. The gastrointestinal tract (GIT) is particularly vulnerable, yet its dysfunction is often overlooked in ECMO management. This editorial synthesizes current literature and pathophysiological principles to analyze the mechanisms of GIT injury during VA-ECMO support. We examine the impact of VA-ECMO on hemodynamics, microcirculation, and inflammation, with a focus on the heart-gut axis. VA-ECMO compromises gut integrity through multiple interconnected pathways. These include microcirculatory dysfunction due to non-pulsatile flow and vasopressor use, increased left ventricular afterload, and ischemia-reperfusion injury. The phenomenon of “dual circulation” in peripheral VA-ECMO creates a risk of heterogeneous oxygen delivery, potentially leaving the GIT hypoperfused. These insults lead to mucosal barrier failure, bacterial translocation, and systemic inflammation, driving sequential organ failure. Early recognition of gut dysfunction, through clinical monitoring and biomarkers, is challenging but critical. Given the high morbidity and mortality associated with VA-ECMO, the GIT must be acknowledged as a critical target organ. A paradigm shift integrating gut-protective strategies, such as meticulous fluid management, enteral nutrition, and monitoring for signs of hypoperfusion into standard VA-ECMO protocols is essential to improve patient outcomes.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"16"},"PeriodicalIF":1.2,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12769693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906118","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":"Feasibility of anticoagulation-free peripheral veno-arterial extracorporeal membrane oxygenation in re-do lung transplantation.","authors":"Chitaru Kurihara, Yudai Miyashita, Taisuke Kaiho, Dai Yamanouchi","doi":"10.1007/s10047-025-01541-8","DOIUrl":"10.1007/s10047-025-01541-8","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the feasibility and safety of anticoagulation-free peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) during lung re-transplantation and to assess its impact on blood transfusion requirements and clinical outcomes.</p><p><strong>Methods: </strong>In this single-center retrospective cohort (January 2023-April 2025), we included adults undergoing bilateral re-do lung transplantation on peripheral VA-ECMO with an anticoagulation-avoidance protocol; primary lung transplants were not included. Data on patient demographics, intraoperative transfusion volumes, postoperative complications, and survival were collected. The primary outcomes were intraoperative packed red blood cell transfusion volume and overall survival; secondary outcomes included incidence of primary graft dysfunction, acute kidney injury, and hemorrhagic and thromboembolic events. Continuous variables are reported as medians with interquartile ranges, and survival was estimated using the Kaplan-Meier method.</p><p><strong>Results: </strong>Seven patients (median age, 42 years; range, 30-56 years) underwent re-transplantation for chronic lung allograft dysfunction. The median intraoperative transfusion requirement was 560 ml (interquartile range 280-1050 ml). One patient developed primary graft dysfunction of grade 3and two developed stage 3 acute kidney injury requiring renal replacement therapy. Two developed deep venous thrombosis nonrelated to ECMO cannulation; no pulmonary embolism occurred. At a median follow-up of 469 days, all patients survived without evidence of recurrence of chronic lung allograft dysfunction.</p><p><strong>Conclusions: </strong>Full anticoagulation-free peripheral VA-ECMO during lung re-transplantation is feasible and safe, with acceptable complication rates and potential reduction in transfusion requirements. Larger, multicenter studies are warranted to confirm these findings.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"15"},"PeriodicalIF":1.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145756796","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":"Extracorporeal hemoperfusion as an adjunctive therapy for liver failure.","authors":"Navid Shafigh, Ameneh Jafari, Haleh Alipour, Batoul Khoundabi, Seyed Mohammad Reza Hashemian","doi":"10.1007/s10047-025-01542-7","DOIUrl":"10.1007/s10047-025-01542-7","url":null,"abstract":"<p><p>Liver failure, whether due to alcoholic liver disease or hepatic malignancy, often leads to acute-on-chronic liver failure (ACLF), necessitating liver transplantation. A major challenge in managing these patients is the acute decompensation phase, during which hepatic toxins and inflammatory mediators accumulate, resulting in multi-system dysfunction. While liver transplantation remains the most effective treatment, artificial liver support systems, particularly extracorporeal blood purification, offer potential benefits. Hemoperfusion, utilizing solute adsorption via a solid agent, provides an alternative to conventional dialysis, which is limited by membrane permeability. In this case series, we report our experience using HA330 hemoperfusion in combination with standard therapy for liver failure patients treated at our single-center hospital from 2023 to 2024. Extracorporeal blood purification with an adsorptive cartridge (HA330, Jafron, China) was employed as an adjunctive strategy to standard care. Our findings suggest that hemoperfusion may serve as a valuable supportive therapy for liver failure patients requiring transplantation. However, larger cohort studies are necessary to confirm its safety and efficacy.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"14"},"PeriodicalIF":1.2,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751988","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}