Artificial organs最新文献

{"title":"Neurophysiological Effect of Transcutaneous Electrical Spinal Cord Stimulation in Chronic Complete Spinal Cord Injury.","authors":"E L McNicol, B Osuagwu, M Purcell, E J McCaughey, C Lincoln, L Cope, A Vučković","doi":"10.1111/aor.15050","DOIUrl":"https://doi.org/10.1111/aor.15050","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous electrical spinal cord stimulation combined with activity-based therapy (TESCS-ABT) holds promising potential for motor rehabilitation of spinal cord injury (SCI). However, its effectiveness in individuals with chronic complete SCI remains largely unexplored, despite recent evidence suggesting that many of these individuals exhibit signs of neurological incompleteness. This study was a prospective, single-arm, open-label trial that investigated the neurophysiological effects of TESCS-ABT in chronic complete SCI and assessed whether any changes translate into functional improvements.</p><p><strong>Methods: </strong>Nine participants with chronic complete SCI were recruited for a two-phase trial, including 6 weeks of FES-conditioning and 16 weeks of TESCS-ABT. Neurophysiological, neurological and functional assessments were conducted at six timepoints throughout the study: baseline; after the FES-conditioning phase; after 6, 10, and 16 weeks of TESCS-ABT; and 12 weeks after completion of the intervention.</p><p><strong>Results: </strong>All participants exhibited increases in synchronized neural signals to muscles in high frequency bands, with limited improvements in corticospinal and spinal excitability. The magnitude and consistency of these neurophysiological changes varied among participants and were influenced by limb dominance. Neurophysiological improvements did not consistently translate into meaningful gains in strength or function.</p><p><strong>Conclusions: </strong>These findings suggest that the neurophysiological effects of TESCS-ABT depend on the presence of residual supraspinal connectivity in chronic complete SCI. This SCI population demonstrate a more limited response compared to previous reports in individuals with incomplete SCI. This study provides important insights into the mechanisms and potential limitations of TESCS-ABT, helping to guide future research toward optimizing the therapy and identifying those most likely to benefit.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT05522920.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526282","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":"Repetitive Grasping After Stroke Assisted by Functional Electrical Stimulation.","authors":"Chiara Höhler, Satoshi Endo, Joachim Hermsdörfer, Lucille Cazenave, Hossein Kavianirad, Klaus Jahn, Carmen Krewer","doi":"10.1111/aor.15033","DOIUrl":"https://doi.org/10.1111/aor.15033","url":null,"abstract":"<p><strong>Background: </strong>Grip force requirements for grasping and releasing objects when hand opening and closing is assisted by Functional Electrical Stimulation (FES) were investigated. To understand whether FES can be useful in assisting these motion primitives, the following requirements were investigated: (i) producing sufficient force, (ii) sustaining this force for an adequate duration, (iii) successfully releasing the object, and (iv) monitoring the onset of muscle fatigue during repetitive grasping.</p><p><strong>Methods: </strong>In an observational cross-sectional design, hemiparetic patients after stroke were instructed to repetitively grasp and release a sensorized object at maximum voluntary contraction while receiving FES assistance (3 s each of finger flexor and extensor stimulation). Outcome variables included clinical grip force data of the paretic and non-paretic hand. Grip force metrics, corresponding to each investigated requirement, such as the maximum applied grip force (GFmax), the amount of time of grip force maintained in the \"GFtarget ± 10% window,\" and the force level during the assisted release (release ratio), were extracted during the FES-assisted grasping protocol. Additionally, changes in GFmax across repetitions were analyzed to investigate muscle fatigue.</p><p><strong>Results: </strong>The median GFmax of 16 analyzed patients (mean 3.4 months post stroke) was 6.9 N (2.2-56.5 N), with severely impaired patients producing significantly lower values than the mildly/moderately impaired. The maximum grip force level was maintained for a median of 1.8 s, and the median object release ratio was significantly higher in patients with spasticity.</p><p><strong>Conclusion: </strong>All patients were able to produce grip force during FES assistance and maintained the grip force level across repetitions, without physiologically meaningful fatigue. The grip forces produced by the patients were similar to those found in real-life object handling in healthy subjects and very close to the reference values required by stroke patients for object transportation. In addition, the repetitive grasping did not lead to a significant muscle fatigue. This grip force produced while having no relevant fatigue highlights the assistive potential of FES in activities of daily living. However, these effects need to be verified for the grasping of real-life objects.</p><p><strong>Trial registration: </strong>This trial was registered on September 29, 2021 (registration number: DRKS00025889).</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504687","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":"New Findings on Pulsatile ECMO: Verification of the Potential to Improve Antithrombogenicity of a Membrane Oxygenator Using Pump-Generated Pulsatile Flow in an Innovative Animal Model.","authors":"Hironobu Sakurai, Tatsuki Fujiwara, Katsuhiro Ohuchi, Wataru Hijikata, Daiki Toda, Yui Tanaka, Orolzod Bumerdene, Sayaka Suzuki, Takehiro Iwanaga, Tomoyuki Fujita","doi":"10.1111/aor.15043","DOIUrl":"https://doi.org/10.1111/aor.15043","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal membrane oxygenation (ECMO) provides mechanical circulatory and respiratory support. However, thrombus formation in the circuit can lead to hemorrhagic complications, requiring improvements in ECMO anti-thrombogenicity. Few studies have reported the effect of pulsatile flow on thrombus formation in ECMO circuits. This study evaluated how pulsatile flow affects thrombus formation inside the membrane oxygenator.</p><p><strong>Methods: </strong>This study was conducted in pigs (n = 5) using an experimental model in which each pig was connected to two different ECMO circuits: one with steady flow (via the jugular vein and carotid artery) and the other with pulsatile flow (via the femoral vein and artery). The pulsatile waveform was generated as an upward sinusoidal waveform added to the baseline frequency. Both circuits were set to a mean flow rate of 2 L/min and operated for 4 h without anticoagulation. Thrombus formation in the membrane oxygenators was observed during and after circulation. The thrombus area was quantified using image analysis.</p><p><strong>Results: </strong>All experiments were completed with stable hemodynamics. The pressure in the pulsatile circuit was confirmed to be a pulsatile waveform. The thrombus area in the steady flow circuits was 81.5%, 10.6%, 42.1%, 60.2%, and 96.7%, while those in the pulsatile flow circuits were 6.2%, 5.2%, 8.4%, 9.9%, and 65.8%, respectively. The thrombus area in the pulsatile flow circuit tended to be smaller than that in the steady flow circuit.</p><p><strong>Conclusions: </strong>Pulsatile flow with a specific waveform may reduce thrombus formation in membrane oxygenators, potentially enhancing the anti-thrombogenicity of ECMO circuits.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526283","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":"Current and Future State of Advanced Heart and Lung Failure Therapies: Highlights From the International Society for Heart and Lung Transplantation 45th Annual Meeting and Scientific Sessions.","authors":"Nayeem Nasher, Brandon E Ferrell, Stephen J Forest, Daniel J Goldstein","doi":"10.1111/aor.15035","DOIUrl":"https://doi.org/10.1111/aor.15035","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473941","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":"Near-Infrared Spectroscopy for Preventing Limb Ischemia in Extracorporeal Membrane Oxygenation.","authors":"Bongyeon Sohn, Heemoon Lee","doi":"10.1111/aor.15045","DOIUrl":"10.1111/aor.15045","url":null,"abstract":"<p><strong>Background: </strong>Limb ischemia is a serious complication of venoarterial (VA) extracorporeal membrane oxygenation (ECMO), potentially resulting in amputation, rhabdomyolysis, or death. This study aimed to evaluate the effectiveness of near-infrared spectroscopy (NIRS) monitoring in the early detection and prevention of limb ischemia in peripheral VA ECMO.</p><p><strong>Methods: </strong>We retrospectively reviewed 166 patients who underwent peripheral VA ECMO between January 2018 and December 2022. Patients were categorized into two groups based on the implementation of NIRS monitoring (Before-NIRS [n = 83] vs. After-NIRS [n = 83]). An inverse probability of treatment weighting (IPTW)-adjusted analysis was conducted.</p><p><strong>Results: </strong>Baseline characteristics were not significantly different between the groups. The ECMO weaning success rate was significantly higher in the After-NIRS group (45.9% vs. 63.4%, p = 0.026). However, survival to discharge did not differ significantly (31.8% vs. 42.7%, p = 0.174). The incidences of rhabdomyolysis and acute limb ischemia were significantly lower in the After-NIRS group (10.6% vs. 1.2% and 11.8% vs. 0%, respectively). In the After-NIRS group, a decrease in NIRS values was observed in three patients, prompting timely placement of distal perfusion catheters. None of these patients developed limb ischemia.</p><p><strong>Conclusions: </strong>After the implementation of NIRS monitoring, no cases of limb ischemia were observed. NIRS enables early identification of limb malperfusion, facilitates timely intervention, and reduces unnecessary distal perfusion catheter placement. As a non-invasive, real-time monitoring modality, NIRS offers continuous assessment of limb perfusion and plays a valuable role in the early prevention of limb ischemia in patients undergoing peripheral VA ECMO.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332403","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":"Response to: \"Machine Perfusion Organ Preservation: Highlights From the American Transplant Congress 2024\".","authors":"Haizam Oubari, Yanis Berkane, Alexandre Lellouch","doi":"10.1111/aor.15046","DOIUrl":"https://doi.org/10.1111/aor.15046","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324371","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":"Ghost Cells as a Two-Phase Blood Analog Fluid-Optical Thrombus Growth Detection Using Particle Image Velocimetry.","authors":"Benjamin J Schürmann, Pia Creutz, Thomas Schmitz-Rode, Ulrich Steinseifer, Johanna C Clauser","doi":"10.1111/aor.15042","DOIUrl":"https://doi.org/10.1111/aor.15042","url":null,"abstract":"<p><strong>Background: </strong>In vitro thrombosis tests for mechanical circulatory support systems lack standardized ISO guidelines. A major limitation of current approaches is the absence of continuous thrombus monitoring, as terminated experiments at a single time point fail to capture the dynamic nature of thrombus formation. However, spatially resolved thrombus formation and its underlying dynamics are crucial for the optimization of mechanical circulatory support systems.</p><p><strong>Methods: </strong>In this study, we present a high-resolution thrombus monitoring approach using particle image velocimetry with a thrombogenic, two-phase blood analog fluid, designated as \"ghost blood\". Ghost blood consists of plasma and ghost cells, which are hemoglobin-depleted erythrocytes. We validate and quantify the particle image velocimetry with ghost blood and use this combination to monitor thrombus growth.</p><p><strong>Results: </strong>The validation demonstrated velocity fields in the FDA-pump are consistent with existing literature, confirming the usability of ghost blood in particle image velocimetry. The use range of ghost blood is quantified as a formula to determine the maximum possible optical penetration depth. Finally, thrombus growth was successfully monitored in the FDA-pump.</p><p><strong>Conclusion: </strong>In this proof of principle study, we grew a thrombus in the FDA-pump and were able to monitor its growth from a first thrombus thread to a complete obstruction of the flow. This approach enables both the localization and the temporal growth of the thrombus to be visualized and thereby provides a foundation for future advancements in thrombosis assessment and the optimization of mechanical circulatory support systems.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315785","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":"Thoracic Organ Transplantation and Device Therapies for Advanced Heart and Lung Failure: Highlights From the 105th Annual Meeting of the American Association for Thoracic Surgery.","authors":"Nayeem Nasher, Vakhtang Tchantchaleishvili, Keshava Rajagopal","doi":"10.1111/aor.15044","DOIUrl":"https://doi.org/10.1111/aor.15044","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315786","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":"Physiological Control of Realheart Total Artificial Heart.","authors":"Emanuele Perra, Daniel Jonasson, Shaikh Faisal Zaman, Nils Brynedal Ignell, Michael Broomé, Thomas Finocchiaro, Ina Laura Perkins, Seraina Anne Dual","doi":"10.1111/aor.15036","DOIUrl":"https://doi.org/10.1111/aor.15036","url":null,"abstract":"<p><strong>Background: </strong>Heart failure (HF) affects approximately 64 million patients worldwide, where the heart's impaired ability to pump blood leads to reduced quality of life and a high 5-year mortality rate. Total artificial hearts (TAHs) offer a promising solution, but to ensure a good quality of life and prolong life expectancy for end-stage HF patients, TAHs must adapt to the body's varying metabolic demands.</p><p><strong>Methods: </strong>This study evaluates the physiological control performance of the Realheart TAH using a hybrid mock circulation loop that simulates dynamic physiological states, such as sleep, rest, and exercise. The Realheart TAH features a preload-based control mechanism that adjusts heart rate (HR) and stroke volume (SV) in response to changes in atrial pressure, closely mimicking the native heart's ability to meet varying blood flow demands. The controller's adaptability and robustness were further tested under different levels of pulmonary vascular resistance (PVR), simulating conditions that challenge flow balance.</p><p><strong>Results: </strong>The results demonstrate that the Realheart TAH maintains flow balance between the right and left ventricles and stabilizes atrial pressures across all tested conditions. During simulated exercise, the controller increased cardiac output (CO) by up to 2.1 times from rest while maintaining stable atrial pressures, compared to a maximum increase of 1.2 times without the controller. During sleep, CO decreased by 25%, whereas a decrease of only 5% was observed without the controller. Under increased PVR, the controller adjusted SV and HR to preserve consistent CO and prevent blood volume build-up in the atria, which could otherwise lead to dangerously high atrial pressures.</p><p><strong>Conclusion: </strong>The physiological control system demonstrated its ability to adapt to rapid transitions between physiological states, although occasional undershoots in pressure were observed during transitions from exercise to rest conditions. This study highlights the Realheart TAH's ability to autonomously adjust to varying physiological conditions and patient needs, showing promise for treating patients with advanced HF. Future work will focus on optimizing the control system to further enhance the device's responsiveness and stability during rapid physiological transitions.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309488","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":"First Human Bladder Transplant","authors":"Aakash M. Shah","doi":"10.1111/aor.15041","DOIUrl":"10.1111/aor.15041","url":null,"abstract":"<div>\u0000 \u0000 <p>First human bladder transplant performed in southern California. The procedure is a testament to surgical advances and offers hope to patients in need of a neobladder.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06337942</p>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1227-1228"},"PeriodicalIF":2.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274121","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}