Artificial organs最新文献

{"title":"Safety of enoxaparin in patients implanted with continuous flow left ventricular assist devices","authors":"Rachel C. Klosko PharmD, BCCP,&nbsp;Bryan Whitson MD, PhD,&nbsp;Brent Lampert DO,&nbsp;Eric McLaughlin MS,&nbsp;Libby Orzel PharmD, BCCP","doi":"10.1111/aor.14908","DOIUrl":"10.1111/aor.14908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The objective of this study is to determine the incidence of major bleeding events in patients implanted with continuous flow left ventricular assist devices (CF-LVADs) bridged with enoxaparin (LMWH) compared to intravenous unfractionated heparin (IV UFH) for a subtherapeutic INR on warfarin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center, retrospective, cohort study was conducted including patients with CF-LVADs implanted between January 1, 2012 and July 1, 2020 who received at least one inpatient dose or outpatient prescription for LMWH or IV UFH at least 60 days after CF-LVAD implantation. The primary endpoint was the incidence of major bleeding.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 176 orders were screened and 90 orders in 62 unique patients were included. Major bleeding and thromboembolic events occurred in 1 (2.5%) versus 4 (10.0%) orders (<i>p</i> = 0.36) and 3 (7.5%) versus 1 (2.5%) orders (<i>p</i> = 0.62) in the LMWH and IV UFH groups, respectively. One patient had a fatal thromboembolic event in each group. More patients receiving IV UFH had minor bleeding events (10 [25.0%] vs. 3 [7.5%]; <i>p</i> = 0.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There was no difference between bleeding and thromboembolic events in patients implanted with CF-LVADs prescribed LMWH or IV UFH for bridging of subtherapeutic INRs. Larger prospective randomized data are needed to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 4","pages":"639-648"},"PeriodicalIF":2.2,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.14908","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142725074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications during extracorporeal membrane oxygenation transfer in Argentina: A multicenter observational study","authors":"Nestor Carrizo,&nbsp;Rafael Avila,&nbsp;Ivan Huespe,&nbsp;Aracelly Perez,&nbsp;Renzo Nuñez,&nbsp;Susana Bauque,&nbsp;Christian Casabella,&nbsp;Mariano Norese,&nbsp;Daniel Ivulich,&nbsp;Veronica Monzon,&nbsp;Fernando Pálizas,&nbsp;Sonia Villarroel","doi":"10.1111/aor.14914","DOIUrl":"10.1111/aor.14914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a lack of documented cases regarding complications during ECMO transfer in middle-income countries. Using portable ECMO devices facilitates patient transport but entails significantly higher costs, necessitating evidence of their practical utility. This study aims to describe complications during ECMO transfer in Argentina and to compare complication rates between the integrated portable ECMO and non-portable ECMO systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter observational retrospective study was conducted across four high-complexity hospitals in Argentina. Patients over 18 years old who underwent ECMO transfer between January 2017 and July 2023 were included. Complications were classified based on the Ericsson severity classification, a widely accepted system that categorizes complications based on their severity and the need for immediate organ support. The effect of the ECMO systems (portable and non-portable ECMO system) on complication rates was assessed using logistic regression weighted by inverse probability weighting (IPWT) analysis after propensity score assessment to adjust for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 65 patients who were transferred for ECMO. Complications occurred in 40% (95%CI: 28%, 52%; n=26) of transfers, with grade 2 complications being the most prevalent at 20% (95%CI 11%, 32%; n=13). Integrated portable ECMO systems were associated with fewer complications during ECMO transfer, showing a crude OR of 0.25 (95%CI 0.08, 0.75), and after adjustment by IPWT, an OR of 0.27 (95%CI 0.08, 0.93).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ECMO transfers in middle-income countries exhibit complication rates similar to those in high-income countries. Our study found fewer complications in transfers using integrated portable ECMO systems and those involving distances exceeding 100 km. These findings suggest that the use of portable ECMO systems, despite their higher costs, may be beneficial in reducing complications during patient transport in middle-income countries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 4","pages":"663-669"},"PeriodicalIF":2.2,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142715083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The journey","authors":"Paul S. Malchesky D.Eng.","doi":"10.1111/aor.14904","DOIUrl":"10.1111/aor.14904","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 2","pages":"171-178"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recent progress in the field of Artificial Organs","authors":"","doi":"10.1111/aor.14913","DOIUrl":"10.1111/aor.14913","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 1","pages":"3-4"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normothermic machine perfusion of explanted livers: Exploratory study of an alternative translational model for end-stage liver disease","authors":"Rachel Todd,&nbsp;L. Leonie van Leeuwen,&nbsp;Matthew Holzner,&nbsp;Leona Kim-Schluger,&nbsp;Maria Isabel Fiel,&nbsp;Daniel Puleston,&nbsp;Sander S. Florman,&nbsp;M. Zeeshan Akhtar","doi":"10.1111/aor.14905","DOIUrl":"10.1111/aor.14905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Normothermic machine perfusion (NMP) is a technique for donor liver preservation and assessment in transplantation. NMP has gained momentum recently by enabling safer use of higher risk organs via organ viability assessment. It also offers a platform for investigating ex vivo organ biology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this exploratory study, we completed a complex vascular reconstruction of explanted, diseased livers from patients undergoing transplantation and then perfused them normothermically on a closed perfusion circuit. We compared these livers to non-diseased donor livers via perfusate samples collected during perfusion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hepatectomized grafts and eight donor livers were perfused for 1 h or longer. Four hepatectomized livers cleared lactate, and all consumed glucose; all control livers cleared lactate, and seven utilized glucose. Significantly higher portal vein flows were achieved in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings illustrate the feasibility of using closed-circuit NMP as a platform to study hepatectomized organs, which could reshape the research landscape in mechanisms of disease and applied therapeutics for patients with end-stage liver disease.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"431-440"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Battlefield mechanical ventilation and extracorporeal membrane oxygenation: A scoping review","authors":"Mateo C. Houle,&nbsp;Michal J. Sobieszczyk,&nbsp;Whittney A. Warren,&nbsp;John C. Hunninghake,&nbsp;Jess T. Anderson,&nbsp;Michael A. Gonzales,&nbsp;Terence P. Lonergan,&nbsp;Valerie G. Sams,&nbsp;Robert A. De Lorenzo,&nbsp;Michael J. Morris","doi":"10.1111/aor.14911","DOIUrl":"10.1111/aor.14911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Casualties of military conflicts suffer a multitude of injuries, and recent research has documented a significant number develop acute respiratory distress syndrome (ARDS). The present study undertakes a scoping review of research on the treatment of ARDS in combat casualties near the battlefield.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We review the extent of the current ARDS care, from intubation and mechanical ventilation (MV) to the use of extracorporeal membrane oxygenation (ECMO), and how the respective echelons of care across the Military Health System (MHS) are involved in the care of these patients. Online databases were used to identify article published 1988–2022, from which we selected 112 publications from various countries including the USA, UK, Germany, Italy, and India that used military relevant keywords (i.e., battlefield, combat, deployed, military trauma), in the titles or abstract in conjunction with the MeSH descriptors for battlefield respiratory failure, and MV or ECMO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mechanical ventilation and ECMO have clearly moved forward with progressions in technologies and now are routinely used and are well documented in the prehospital setting and during aeromedical transport. Overview of the MHS and descriptive analysis of battlefield casualties are well represented in the literature. There are multiple publications on airway management on the battlefield and innumerable regarding the somewhat comparable civilian prehospital trauma airway management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While there is an abundance of publications on MV in the prehospital and combat environments, there are few case examples of the use of ECMO on the battlefield. Although MV may be required for many combat casualties, airway management failure remains the second leading cause of preventable death on the battlefield.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"353-361"},"PeriodicalIF":2.2,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal liver support systems in patients with acute-on-chronic liver failure: An updated systematic review and meta-analysis","authors":"Haiyu Liu,&nbsp;Zhibo Yang,&nbsp;Qiong Luo,&nbsp;Jianhui Lin","doi":"10.1111/aor.14915","DOIUrl":"10.1111/aor.14915","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The utilization of extracorporeal liver support systems is increasingly prevalent for the management of acute-on-chronic liver failure in clinical settings. Yet, the efficacy of these interventions in terms of tangible clinical benefits for patients remains a matter of debate, underscoring the need for meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An updated meta-analysis was performed to elucidate the relationship between the application of extracorporeal liver support versus standard pharmacological treatment and the prognostic endpoints of patient survival, specifically assessing 1-month and 3-month mortality rates, as well as the incidence of complications such as hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome. Literature were searched via PubMed, EMBASE, and Web of Science.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The meta-analysis revealed the following: the odds ratio for 1-month mortality was 0.63 (95% confidence interval [CIs]: 0.51–0.76), for 3-month mortality was 0.70 (95% CI: 0.61–0.81), for hepatic encephalopathy was 0.81 (95% CI: 0.67–0.97), for spontaneous bacterial peritonitis was 0.66 (95% CI: 0.44–0.99), and for hepatorenal syndrome was 0.68 (95% CI: 0.51–0.92). These results suggest that patients with acute-on-chronic liver failure undergoing extracorporeal liver support system therapy have significantly better survival rates and lower complication incidences compared to those receiving conventional drug therapy. Further subgroup analysis indicated that patients with lower model for end-stage liver disease (MELD) scores and reduced total bilirubin (Tbil) levels demonstrated greater benefits from extracorporeal hepatic support.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study establishes that in the management of acute-on-chronic liver failure, extracorporeal liver support systems confer a survival advantage and reduce complications relative to standard pharmacotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 5","pages":"762-777"},"PeriodicalIF":2.2,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.14915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-time physiological environment emulation for the Istanbul heart ventricular assist device via acausal cardiovascular modeling","authors":"Hammad Ur Rahman,&nbsp;Khunsha Mehmood,&nbsp;Farouk Abdulhamid,&nbsp;Ismail Lazoglu,&nbsp;Vedat Bakuy,&nbsp;Deniz Süha Küçükaksu","doi":"10.1111/aor.14903","DOIUrl":"10.1111/aor.14903","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>The cost and complexity associated with animal testing are significantly reduced by using mock circulatory loops prior. Novel mock circulatory loops allow us to test biomedical devices preclinically due to their flexibility, scalability, and cost-effectiveness. The presented work describes the development of a hardware-in-the-loop platform to emulate human physiology for the Istanbul Heart (iHeart-II) LVAD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A closed-loop system is developed whereby the effect of the LVAD on the heart and vice versa can be studied. An acausal model of the cardiovascular system is calibrated to emulate advanced-stage heart failure. A new prototype of the iHeart-II LVAD is connected between two air-actuated chambers emulating the left ventricle and aortic chambers with PID controllers tracking numerically modeled pressures from the in silico model. A lead–lag compensator is used to maintain fluid level. Controllers are tuned using nonlinear Hammerstein-Weiner models identified using open-loop data. The iHeart-II LVAD is operated at various speeds in its operational range, and the resulting hemodynamics are visualized in real time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Hemodynamic variables, such as LVAD flow rate, aortic, left ventricular, and pulse pressure, demonstrate trends similar to clinical observations. The iHeart-II LVAD achieves hemodynamic normalization at ~3500 rpm for the emulated condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A novel evaluation methodology is adopted to study the performance of the iHeart LVAD under advanced-stage heart failure emulation. The models and controllers used in the platform are readily replicable to facilitate VAD research, pedagogy, design, and development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"410-419"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Useful central mechanical circulatory support system for critical biventricular heart failure associated with high pulmonary vascular resistance","authors":"Naoki Tadokoro,&nbsp;Satoshi Kainuma,&nbsp;Kohei Tonai,&nbsp;Tetsuya Koyamoto,&nbsp;Naonori Kawamoto,&nbsp;Takashi Kakuta,&nbsp;Kimito Minami,&nbsp;Hiroshi Nishioka,&nbsp;Yasumasa Tsukamoto,&nbsp;Satsuki Fukushima","doi":"10.1111/aor.14906","DOIUrl":"10.1111/aor.14906","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Peripheral veno-arterial extracorporeal membrane oxygenation (ECMO) is a powerful life-saving tool; however, it can sometimes induce severe pulmonary edema in patients with critical heart failure. We report favorable outcomes in critically ill patients by using a central ECMO system with an innovative blood perfusion method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 10 patients with severe heart failure and pulmonary edema who were treated with the central ECMO system at our institution between April 2022 and October 2023. The system consists of central cannulation with two inflows from the right atrium and left ventricle, and two outflows to the aorta and pulmonary artery, connected by two Y-connectors to a single ECMO circuit (RALV-AOPA ECMO). In this system, blood flow to the pulmonary artery is adjusted and mean pulmonary artery pressure is limited to &lt;20 mm Hg, which reduces right ventricular afterload and prevents the worsening of pulmonary edema and hemorrhage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six patients were diagnosed with fulminant lymphocytic myocarditis, and four were diagnosed with coronavirus disease 2019-related myocardial injury. The ejection fraction was 6.5 ± 4.1%. The average intraoperative pulmonary vascular resistance was 4.6 ± 1.3 Wood units. After 24 h, the mean pulmonary arterial pressure was 12.8 ± 4.3 mm Hg, and pulmonary vascular resistance was 1.5 ± 0.3 Wood units. The duration of central RALV-AOPA ECMO was 3.7 ± 2.1 days. Finally, six patients were weaned, three received HeartMate3, and one received heart transplantation. At follow-up, all patients remained alive (428 ± 208 days), and two patients experienced cerebrovascular accidents without any lasting sequelae.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The central RALV-AOPA ECMO is an innovative system that achieves early improvement in pulmonary vascular resistance and is safe and feasible for patients with acute biventricular failure and pulmonary edema.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"469-476"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IL-1 receptor antagonist anakinra downregulates inflammatory cytokines during renal normothermic machine perfusion: Preliminary results","authors":"Sarah A. Hosgood,&nbsp;Tom Moore,&nbsp;Alex Walker,&nbsp;Michael L. Nicholson","doi":"10.1111/aor.14909","DOIUrl":"10.1111/aor.14909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The interleukin 1 (IL-1) cytokine group plays a key role in sterile inflammation and may be an important target for transplant-related renal injury. This study examined the effects of anakinra, a non-specific IL-1 receptor antagonist, administered during normothermic machine perfusion (NMP) of porcine kidneys.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Paired porcine kidneys (<i>n</i> = 5 pairs) underwent 15 min of warm ischemia plus 2 h of static cold storage in ice. Kidneys were then perfused with autologous whole blood using an ex vivo NMP platform. Kidneys were randomly allocated to receive anakinra or vehicle administered at the start of NMP. Cortical biopsies were collected at baseline before ischemic injury and at the end of NMP. Functional parameters were recorded and calculated, and inflammatory markers were measured by qPCR and ELISA techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During NMP, there were no statistically significant differences in renal blood flow, urine output, creatinine clearance or fractional excretion of sodium in the anakinra and control groups. The administration of anakinra significantly downregulated transcriptional expression of IL-6, Fas ligand and intercellular adhesion molecule 1 (<i>p</i> = 0.029, 0.029, 0.028, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Anakinra, an IL-1 receptor blocker, successfully attenuated the downstream inflammatory and immune-mediated response within the kidney during NMP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"451-459"},"PeriodicalIF":2.2,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.14909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}