Journal of Artificial Organs最新文献

{"title":"The efforts to cooperate in different fields in blood purification.","authors":"Takehiro Miyasaka, Kiyotaka Sakai","doi":"10.1007/s10047-025-01537-4","DOIUrl":"10.1007/s10047-025-01537-4","url":null,"abstract":"<p><p>The performance of semipermeable membranes, and adsorbents incorporated in blood purification devices depends heavily on the design of blood purification devices. No matter how excellent the semipermeable membranes or adsorbents are, if the devices incorporating them are not well designed, the performance of the semipermeable membranes or adsorbents will not be effectively utilized. For this reason, technical know-how is required to optimally design the blood purification devices, and collaboration with different fields is of great help. We will discuss the efforts of our predecessors in interdisciplinary collaboration in the blood purification, as well as the good transmission of gained knowledge.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":"29 1","pages":"13"},"PeriodicalIF":1.2,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654348","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 data-driven framework for fair and efficient organ transplantation using gradient boosting and adaptive genetic allocation.","authors":"Sangeetha Gnanasambandan, Vanathi Balasubramanian","doi":"10.1007/s10047-025-01512-z","DOIUrl":"10.1007/s10047-025-01512-z","url":null,"abstract":"<p><p>This study proposes a comprehensive data-driven framework aimed at enhancing organ transplantation efficiency through optimized risk assessment, donor-recipient matching, and equitable organ allocation. Utilizing the gradient boosting algorithm (GBA) for risk prioritization, A* search for optimal donor location, the modified convolutional neural network-based hybrid extreme learning classifier (MCNN-HELM) model for precise matching, and an adaptive objective-weighted genetic allocation (AOWGA) algorithm, the framework addresses critical challenges in organ allocation and distribution. The experimental results indicate strong performance metrics, with the integrated system achieving an overall accuracy of 96%, allocation efficiency of 97%, and a fairness index of 0.92. The MCNN-HELM model showed a matching precision of 0.94 and an accuracy of 97.5%, outperforming existing methods. AOWGA surpassed comparative allocation methods, demonstrating an allocation efficiency of 0.96 and a positive outcome rate of 0.95. By integrating these modules, the framework not only improves organ allocation processes but also enhances survival rates and promotes ethical practices in organ distribution. By innovatively integrating these techniques, the framework reduces waiting times, improves patient outcomes, and ensures fair allocation, marking a significant advancement in addressing the persistent organ shortage and setting a new standard for ethical and efficient organ transplantation.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"527-537"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234231","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":"Nomograms to predict outcome for patients undergoing venoarterial extracorporeal membrane oxygenation treatment for septic shock.","authors":"Kunlin Hu, Jing Wei, Xinyu Chi, Jiwang Zhang, Xuanliang Zhao, Liqiu Lu, Yufeng Liao, Shulin Xiang, Bin Xiong","doi":"10.1007/s10047-025-01523-w","DOIUrl":"10.1007/s10047-025-01523-w","url":null,"abstract":"<p><p>Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is increasingly being employed to treat patients with refractory septic shock. Despite its growing use, there is a notable absence of prognostic assessment tools specifically designed for septic shock patients who have received VA-ECMO therapy. The aim of this study is to develop and validate a prognostic model for patients with refractory septic shock undergoing VA-ECMO, and to identify those who may derive the greatest benefit from this treatment. This single-center, retrospective cohort study was conducted at a comprehensive intensive care unit in China. Adult patients with refractory septic shock who received VA-ECMO treatment were included. Two hundred consecutive patients were randomly divided into training and validation cohorts in a 7:3 ratio. Least absolute shrinkage and selection operator regression analysis was employed to select relevant variables for the logistic regression model, and its performance was tested in both training and validation cohorts based on discrimination, calibration, and net benefit. Between January 2019 and September 2024, 293 patients were screened, 200 of whom were eligible and were divided into development (n = 140) and validation (n = 60) cohorts. The 28-day survival rate was 23.0%, and median duration of ECMO run was 6.0 days (IQR 2.0-8.0). Age, APACHE II score at ICU admission, immunosuppression status, hypertension, IL-6, and APTT measured within 6 h before ECMO initiation were the six predictors included in the nomograms. The nomogram demonstrated strong discriminative power in the training cohort (area under the curve [AUC]: 0.873, 95% CI 0.812-0.929), as well as in the validation cohort (area under the curve [AUC]: 0.818 (95% CI 0.687-0.920). The model's reliability in predicting outcomes was evident from the high consistency between predicted probabilities and observed proportions during calibration. Decision curve analysis indicated that the model's clinical benefit was advantageous. The novel validated nomogram is designed to predict outcomes after VA-ECMO treatment in individuals with refractory septic shock. It can support physicians in performing precise mortality risk evaluations and making more informed decisions regarding the application of VA-ECMO treatment.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"589-599"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955568","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":"Investigating optimal drainage cannula for venovenous extracorporeal membrane oxygenation: impact of side holes on blood oxygenation - an in vitro study.","authors":"Konomi Togo","doi":"10.1007/s10047-025-01525-8","DOIUrl":"10.1007/s10047-025-01525-8","url":null,"abstract":"<p><p>Venovenous extracorporeal membrane oxygenation (VV ECMO) relies on effective blood drainage, and cannula design plays a crucial role in optimizing blood oxygenation. Recirculation, where oxygenated blood returns to the drainage cannula without systemic circulation, can negatively impact ECMO efficacy. It was hypothesized that drainage cannulae with a longer side hole portion would reduce recirculation and improve blood oxygenation. This in vitro study investigated the impact of the length of the side hole portion and the intervals of the side holes on blood oxygenation in a simulated VV ECMO circuit. Five cannulae were prepared with the following side holes: (a) 1-cm intervals from the tip to 5 cm; (b) 1-cm intervals from the tip to 10 cm; (c) 1-cm intervals from the tip to 15 cm; (d) 3-cm intervals from the tip to 15 cm; and e) 5-cm intervals from the tip to 15 cm. With blood drained from the right atrium and returned to the superior vena cava, recirculation rates and PaO₂ at 150 s after ECMO initiation (descending PaO₂ order) were: (c) 32 ± 1% and 160 ± 4 mmHg; (d) 35 ± 1% and 149 ± 5 mmHg; (b) 38 ± 1% and 139 ± 5 mmHg; (e) 39 ± 1% and 133 ± 4 mmHg; and (a) 57 ± 3% and 94 ± 7 mmHg. These findings suggest that cannulae with a longer side hole portion may optimize blood oxygenation by reducing recirculation. Furthermore, shorter side hole portions on drainage cannulae are not recommended for VV ECMO.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"636-641"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955501","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 case of fatal acute saddle embolism of the terminal aorta after long-term support using Impella CP.","authors":"Satoru Kishimoto, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka","doi":"10.1007/s10047-025-01499-7","DOIUrl":"10.1007/s10047-025-01499-7","url":null,"abstract":"<p><p>A 69-year-old male diagnosed with subacute myocardial infarction was subsequently transferred to our institution. Upon admission, echocardiography revealed ventricular septal rupture (VSR). The patient was promptly supported via venoarterial (VA) extracorporeal membrane oxygenation (ECMO) and Impella CP before surgical VSR repair on the 12th day of admission. Following surgery, the patient decided to be transferred to the intensive care unit under new VA-ECMO assistance. Subsequently, Impella CP removal and arterial cannula reinsertion were performed at the ipsilateral site, with no pulsatile bleeding observed from the arterial cannulation site. Emergency aortography revealed a contrast defect at the terminal aorta. Owing to the possibility of acute thrombotic occlusion, the Fogarty procedure was performed through the bilateral common femoral artery (CFA); however, no thrombus retrieved. Contrast-enhanced computed tomography revealed complete occlusion of the bilateral common iliac arteries, extending to the abdominal aorta. The uncontrollable, rapid progression of acidemia resulted in sudden cardiac arrest. Acute arterial occlusion leading to fatal outcomes can occur because of thrombosis following long-term Impella CP use. Impella-associated thrombi can form around the shaft of a mixed area of blood flow caused by the interaction between Impella and ECMO and often develop distal to the aortic arch, which is often overlooked during routine examinations. Therefore, planning for long-term Impella with ECMO support must utilize various imaging modalities to search for thrombi and prepare several means of revascularization during Impella removal.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"622-626"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604955","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 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":"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":"627-630"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","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":"Artificial pancreas: the past and the future.","authors":"Hiroyuki Kitagawa, Masaya Munekage, Satoru Seo, Kazuhiro Hanazaki","doi":"10.1007/s10047-025-01510-1","DOIUrl":"10.1007/s10047-025-01510-1","url":null,"abstract":"<p><p>In glucose management using continuous insulin infusion, artificial pancreas systems prevent blood glucose fluctuations and severe hypoglycemia using insulin pumps and continuous glucose monitoring. Advances in both insulin pumps and continuous glucose monitoring have enabled the transition from sensor augmented pump therapy, where insulin delivery is manually adjusted, to hybrid closed-loop insulin pump therapy, which automatically adjusts basal insulin infusion. Furthermore, fully automated insulin delivery systems that adjust insulin based on variations due to meals and exercise are now possible. These systems have been primarily applied to patients with type 1 diabetes but are now expanding to all insulin-dependent patients. Wearable artificial pancreas systems measure glucose levels in subcutaneous tissue fluid, while bedside artificial pancreas systems measure glucose levels in venous blood, making them suitable for managing the highly variable blood glucose levels of perioperative and critically ill patients. Future developments are anticipated to integrate the benefits of both wearable and bedside systems.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"514-521"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142664","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":"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":"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":"631-635"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","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}

{"title":"Survival and hospitalization in home versus Institutional hemodialysis-nine years of follow up.","authors":"Verica Todorov Sakic, Petar Djuric, Ana Bulatovic, Jelena Bjedov, Aleksandar Jankovic, Snezana Pesic, Zivka Djuric, Radomir Naumovic","doi":"10.1007/s10047-025-01511-0","DOIUrl":"10.1007/s10047-025-01511-0","url":null,"abstract":"<p><p>Increasing interest in home dialysis treatments are driven by better outcomes, less complications, patients desire and economic reasons. We compared 26 prevalent home hemodialysis (HHD) patients with 52 matched institutional hemodialysis patients (IHD) in survival and morbidity. Median age for HHD and IHD patients was 55,7 and 56 years respectively, and 77% were men. HHD patients had significantly better anemia control (Hgb level 12.2 ± 1.7 vs. 10.8 ± 1.3gr/dl; p = 0,001 respectively), and significantly higher albumin and cholesterol levels than IHD (42.5 ± 2 vs. 39 ± 3 g/l, p = 0.001; 5.1 ± 1 vs.4.7 ± 0.8 mmol/l, p = 0.05, respectively). During the nine years of follow up, there was no difference between groups in overall number of hospitalization (3.7 ± 3.3 vs. 3.9 ± 2.8; p = 0.47), nor in annual admission rate for everyone cause (0.5 ± 0.4 vs. 0.6 ± 0.4, p = 0.28), but IHD patients stayed longer in hospital (7.4 ± 9.8 days vs. 9.3 ± 8.7 days; p = 0.05). Cause-specific morbidity showed that IHD patients had more frequent annual admission rate for cardiovascular diseases (CVD) than HHD (0.4 ± 0.3 vs. 0.2 ± 0.1 respectively, p = 0.05), while there were no differences for infections (0.3 ± 0.3 vs. 0.3 ± 0.2 respectively, p = 0.9) nor vascular access (VA) dysfunction (0.4 ± 0.3 vs. 0.3 ± 0.3 respectively, p = 0.3). Also annual in-hospital stay for CVD (3.0 ± 3.1 vs. 4.0 ± 4.5 days; p = 0.5), infection (6,4 ± 7,5 vs. 5,7 ± 7,6 days; p = 0,6) and VA dysfunction (6.0 ± 7.0 vs. 7.7 ± 7.8 days; p = 0,5) did not differ between HHD and IHD group. As revealed by Kaplan Meier curve, survival in HHD and IHD patients were 92.3% vs. 90.4% at 3 years, 84.6% vs. 70.2% at 5 years, and 55.7% vs. 50% at 9 years (log-rank test p = 0,5). HHD provides better anemia and nutrition control; shorter hospitalizations and less frequent hospitalizations for CVD.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"608-614"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093620","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":"Key markers and detection methods for evaluating platelet dysfunction in mechanical circulatory support devices.","authors":"Zhenling Wei, Zhuo Li, Wangwang Su, Longhui Cheng, Liudi Zhang","doi":"10.1007/s10047-025-01520-z","DOIUrl":"10.1007/s10047-025-01520-z","url":null,"abstract":"<p><p>Mechanical circulatory support devices (MCSDs) have emerged as life-saving interventions for patients with end-stage heart failure. However, the non-physiological shear stress (NPSS) generated by MCSDs is a known precipitant of platelet dysfunction, augmenting risks of thrombotic and bleeding complications. Addressing this issue necessitates innovative approaches to attenuate platelet dysfunction, thereby enhancing the safety of MCSDs. This review synthesizes knowledge pertaining to the normal hemostatic process, the implications of NPSS on platelet function, the array of markers extensively employed to assess platelet dysfunction, and relevant detection assays, within the scope of MCSDs-related hemocompatibility. NPSS can induce platelet activation and receptor shedding, causing both thrombosis and bleeding. The use of fluorescence-activated cell sorting (FACS) to monitor changes in markers, including platelet surface receptors, P-selectin, platelet monocyte aggregation (PMA), platelet-derived microparticles (PDMPs), and phosphatidylserine (PS), Enzyme-Linked Immunosorbent Assay (ELISA) for platelet secretion analysis, and the modified prothrombinase platelet activity state (PAS) for thrombin assessment, are central to investigating these consequences. PS and thrombin, particularly, present unique responses to NPSS, underscoring their potential as targeted markers for platelet dysfunction research. Additionally, assessments of morphological shifts and platelet aggregation, through scanning electron microscopy (SEM) and fluorescence microscopy provide a more visualized evaluation of NPSS-mediated platelet dysfunction. Combining distinct markers and assays is essential to understanding and potentially mitigating NPSS-induced complications in MCSD therapy. Future research should focus on validating NPSS-specific biomarkers, standardizing detection methodologies, and elucidating interactions with MCSD-induced hemolysis and coagulopathy, ultimately improving safety and efficacy.</p>","PeriodicalId":15177,"journal":{"name":"Journal of Artificial Organs","volume":" ","pages":"479-490"},"PeriodicalIF":1.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742181","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}