Artificial organs最新文献

{"title":"Integrating Dialysis in Ex Situ Machine Perfusion: A Systematic Review and Meta-Analysis of Outcomes.","authors":"Yomna E Dean, Sean Frisbie, James Gaston, Diwakar Phuyal, Bahareh Tabatabaei, Florian Huwyler, Matthias Pfister, Jonas Binz, Antonio Rampazzo, Gábor Szabó, Mark W Tibbit, Pierre-Alain Clavien, Bahar Bassiri Gharb","doi":"10.1111/aor.70011","DOIUrl":"https://doi.org/10.1111/aor.70011","url":null,"abstract":"<p><strong>Background: </strong>Ex situ machine perfusion (EVMP) leads to the accumulation of metabolites and electrolytes in the perfusate. This review aimed to examine the impact of dialysis on biochemical and functional parameters during EVMP.</p><p><strong>Methods: </strong>A systematic review was conducted per PRISMA guidelines. Studies integrating dialysis in lungs, liver, pancreas, and heart EVMP, either in large animals or humans, were included. Biochemical and metabolic parameters, organ weight, inflammatory markers, and organ-specific outcomes were extracted. Meta-analyses and longitudinal regression were conducted.</p><p><strong>Results: </strong>Nineteen studies were included. Dialysis maintained sodium (p = 0.17), potassium (p = 0.75), lactate concentrations (p = 0.3), and pH (p = 0.1). A significant decrease was seen in chloride concentration (p < 0.01), while calcium levels increased significantly over time in the dialysis group (p < 0.001). Interleukin 6 was elevated in dialysis relative to the controls during porcine lung perfusion (p < 0.05) and trended toward significance in humans (p = 0.08). During heart perfusion, the dialysis group exhibited higher cardiac contractility, expressed as a percentage of baseline (71.2% ± 7.7 vs. 55.3% ± 8.2, p < 0.05). During liver perfusion, bile production increased significantly from baseline (β = +1.85 IU/L/h, p < 0.001). Lung compliance was stable in the dialysis (β = -2.34 mL/H₂O/h, p = 0.36) and control groups (β = +0.12 mL/H₂O/h, p = 0.27).</p><p><strong>Conclusion: </strong>Dialysis maintained biochemical homeostasis during EVMP. Significant functional benefits were seen in cardiac EVMP and should be investigated in other organs, including appropriate control groups.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237789","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":"Preoperative Atrial Fibrillation Does Not Impact Long-Term Survival and Complications in Left Ventricular Assistance Device Recipients.","authors":"Miloud Cherbi, Vincent Galand, Valentin Barré, Pierre Groussin, Melvyn Dezecot, Paul Gautier, Philippe Maury, Clément Delmas, Erwan Flecher, Raphael Martins","doi":"10.1111/aor.70020","DOIUrl":"https://doi.org/10.1111/aor.70020","url":null,"abstract":"<p><strong>Introduction: </strong>A substantial proportion of patients receiving left ventricular assist devices (LVADs) present with pre-existing atrial fibrillation (AF). However, the prognostic significance of AF-particularly regarding overall survival and ventricular arrhythmias (VAs)-remains unclear.</p><p><strong>Methods: </strong>Patients included were those from the multicenter ASSIST-ICD observational study. The association between AF and the primary endpoint of all-cause mortality was evaluated using a 1:1 propensity score-matched cohort. Secondary outcomes included cardiovascular and non-cardiac mortality, bleeding, stroke, pump thrombosis, and the occurrence of early (≤ 30 days post-implant) and late VAs.</p><p><strong>Results: </strong>Among 652 LVAD recipients, 286 patients (43.9%) had a history of AF before LVAD implantation, with a median follow-up of 9.1 months (2.5-22.1). AF patients were older, with higher rates of dilated cardiomyopathy, a history of VAs, and longer heart failure duration. After matching, AF was not associated with higher mortality (HR 0.93 [0.69-1.26]). AF subtype (paroxysmal, persistent, permanent) had no impact on mortality. There were no significant differences in cardiovascular/non-cardiac mortality, bleeding, ischemic stroke, pump thrombosis, or early VAs. However, AF was linked to a higher incidence of late VAs.</p><p><strong>Conclusion: </strong>In this large multicenter study, AF before LVAD implantation was not associated with increased risks of mortality, bleeding, stroke, or pump thrombosis, but was linked to a higher incidence of late VAs. These findings, based on earlier-generation devices, should be interpreted cautiously given the recent adoption of the HeartMate 3, offering improved hemocompatibility. Further studies are needed to identify LVAD patients where AF carries clinical significance and guide optimal management.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224634","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":"A Comparison Study Between Electrical Muscle Stimulation and Transcutaneous Electrical Nerve Stimulation on Treatment of Myofascial Pain Syndrome.","authors":"Seekaow Churproong, Benjamin Metcalfe, Polly Mcguigan, Dingguo Zhang","doi":"10.1111/aor.70017","DOIUrl":"https://doi.org/10.1111/aor.70017","url":null,"abstract":"<p><strong>Background: </strong>Myofascial pain syndrome (MPS) originates from myofascial trigger points (MTPs)- hypersensitive nodules commonly found in the trapezius muscle (TM) that cause pain and functional limitations. While transcutaneous electrical nerve stimulation (TENS) is a conventional treatment, a novel approach combining electrical muscle stimulation (EMS) with active stretching (AS) has recently been developed (EMS + AS).</p><p><strong>Methods: </strong>EMS electrodes were placed transversely across muscle fibers to induce localized contractions and thus greater stretch of MTP-containing regions compared to AS alone. EMS plays a role similar to a therapist's hand in passive stretching in that it provides resistance force. Forty-one participants with MTPs in the TM received single sessions of EMS + AS, sham stimulation (SS) + AS, and TENS. Each session included three 10-s stimulations with 10-s rest intervals. Pain intensity (PI), pressure pain threshold (PPT), and surface electromyography (sEMG) for maximal voluntary contraction (%MVC) amplitude analysis of TM function improvement were the three outcome measures used to assess treatment effectiveness. To evaluate the immediate effects of short-duration treatments with EMS + AS compared to SS + AS and TENS. All three treatments were applied in a randomized order.</p><p><strong>Results: </strong>EMS + AS showed significant improvements in PI and PPT (t₍₄₀₎ = -6.01 and t₍₄₀₎ = 5.38, p < 0.001, respectively). EMS + AS showed a small sEMG activity during TM function improvement of 0.49 ± 0.056 %MVC at post-treatment, normalized to pre-treatment values. Compared to SS + AS and TENS, EMS + AS significantly increased PPT changes (F_(2,120) = 13.442, p < 0.001); however, there were no significant differences in PI or mean %MVC.</p><p><strong>Conclusions: </strong>This study demonstrates that EMS generates a local contraction instead of a full contraction for a muscle. EMS's effect is related to the aim of mimicking passive stretching performed by the therapist's hand. Ultimately, EMS + AS has the potential to be an effective approach for alleviating MPS symptoms.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224577","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":"Biliary Glutathione as a Potential Marker for Viability Assessment of Cholangiocytes During Normothermic Machine Perfusion of Livers.","authors":"Christina Bogensperger, Hannah Esser, Florian Ponholzer, Benno Cardini, Julia Hofmann, Franka Messner, Rupert Oberhuber, Thomas Resch, Dietmar Öfner, Stefan Schneeberger, Annemarie Weissenbacher","doi":"10.1111/aor.70024","DOIUrl":"https://doi.org/10.1111/aor.70024","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) is increasingly used to assess liver grafts before transplantation. While viability assessment of the hepatocellular compartment has been widely adopted, viability assessment of the biliary compartment remains controversial due to the lack of reliable markers. Glutathione (GSH) plays a key role in bile formation and may serve as a marker for biliary viability. Thus, the present study aimed to investigate the suitability of GSH as a potential marker for biliary viability assessment during NMP.</p><p><strong>Methods: </strong>Between 2018 and 2021, livers undergoing NMP were included in the study. Bile samples were collected at 1 h, 6 h, and at the end of NMP, and then analyzed using enzyme-linked immunosorbent assay (ELISA). Results were correlated with perfusion parameters and clinical outcomes.</p><p><strong>Results: </strong>56 livers underwent NMP during the study period, of which 41 were successfully transplanted (73.2%). Within 1 year after transplantation, 19 patients (46.3%) developed biliary complications. 1-year patient survival was 80.5% and 1-year graft survival (death-censored) was 94.6%. The GSH in transplanted livers showed a significant increase over time (Hour 1: 25.9 ± 31.2 μM vs. End: 108.7 ± 95.3 μM, p < 0.001) and significant inverse correlation with the occurrence of biliary complications after transplantation (p < 0.05). GSH concentration at the first hour measurement was significantly lower in livers that were deemed non-transplantable (11.2 μM vs. 25.9 μM, p = 0.006).</p><p><strong>Conclusions: </strong>Our data show an increase of GSH in bile during liver ex situ NMP. We found a negative correlation between GSH concentration and the development of biliary complications, suggesting GSH as a new marker for biliary viability assessment.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211545","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":"Translating Research Into Clinical Practice and Harnessing Hybrid Technologies Using Electrical Stimulation.","authors":"Tamsyn Street, Gad Alon, Benjamin Metcalfe, Simona Ferrante","doi":"10.1111/aor.70010","DOIUrl":"https://doi.org/10.1111/aor.70010","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136321","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":"Machine Learning-Based Prediction of Life-Threatening Complications During Hemodialysis in Hospitalized Patients With Poor General Conditions.","authors":"Naotaka Kato, Takeshi Goto, Tomoyuki Ohira, Hirotaka Kinoshita, Kugo Kurokawa, Kouhei Naganuma, Chikako Ohminato, Junko Ogasawara, Shingo Hatakeyama, Yoshihiro Sasaki, Kazuyoshi Hirota, Chikara Ohyama","doi":"10.1111/aor.70008","DOIUrl":"https://doi.org/10.1111/aor.70008","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing hemodialysis (HD) face a significantly elevated risk of cardiovascular mortality, with sudden events during treatment posing a critical threat to survival. These risks are particularly pronounced in high-risk populations, such as patients recovering from cardiovascular surgery or those being treated for sepsis. Therefore, the development of effective preventive strategies is essential for improving patient outcomes. This study aimed to develop a machine learning model that uses pretreatment patient characteristics to predict sudden adverse events during HD and within 24 h after treatment in high-risk inpatients at acute care hospitals.</p><p><strong>Methods: </strong>His retrospective study analyzed data from 739 patients who underwent HD at Hirosaki University Hospital between 2018 and 2021. Sudden events were defined as fatal arrhythmia, refractory intradialytic hypotension, or respiratory arrest. A logistic regression model was constructed using backward stepwise selection from 51 patient characteristics (demographic data, clinical parameters, laboratory data, and HD-related information).</p><p><strong>Results: </strong>Among the 739 patients, 17 (2.3%) experienced sudden events. The model identified 23 pre-HD covariates and achieved an area under the receiver operating characteristic curve (AUC) of 0.889. Key covariates included emergency hospitalization (present in 71% of patients with sudden events), recent surgery (76%), shorter HD history, elevated pre-HD heart rate, lower serum albumin levels, and higher C-reactive protein concentrations.</p><p><strong>Conclusions: </strong>Our model enables the early identification of high-risk inpatients receiving hemodialysis using pre-dialysis data, thereby supporting timely clinical interventions, optimized resource allocation, and improved patient safety.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091055","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":"In Vitro Hemocompatibility of the BiVACOR Total Artificial Heart in Continuous and Pulsatile Flow.","authors":"Antony P McNamee, Daniel Timms, Frank Nestler, Nicole Bartnikowski, Amanda Smith, Geoff D Tansley, Michael J Simmonds","doi":"10.1111/aor.70009","DOIUrl":"https://doi.org/10.1111/aor.70009","url":null,"abstract":"<p><strong>Background: </strong>Heart transplantation is curative for advanced heart failure; however, the limited availability of suitable donor organs makes mechanical circulatory support devices a crucial alternative. BiVACOR's total artificial heart (TAH) is a new device that provides full replacement of the organic failing heart to support systemic and pulmonary circulation using a single, magnetically levitated centrifugal rotor. The aim of this study was to assess the in vitro hemocompatibility of the TAH operating in either continuous flow (CF) or pulsatile flow (PF) mode.</p><p><strong>Methods: </strong>Cattle blood was circulated in an in vitro blood loop at 5 L/min against 100 mmHg for 6 h using the TAH in CF (n = 6) or PF (n = 6), which were compared with a reference pump (CentriMag; n = 6). Blood analysis included hematology, plasma free-hemoglobin, and von Willebrand factor (vWF) multimers.</p><p><strong>Results: </strong>The normalized indexes of hemolysis were 0.004 ± 0.003 g/100 L for CF, 0.004 ± 0.003 g/100 L for PF, and 0.003 ± 0.002 g/100 L for reference. Basic hematology and vWF multimers were affected in a linear manner, but did not vary between flow regimes or devices.</p><p><strong>Conclusions: </strong>BiVACOR's TAH operated in a manner requisite of complete heart support, generated comparable in vitro blood compatibility to the clinically approved reference pump, as evidenced by hematological parameters and vWF analyses. The presence of a large pulse pressure did not impact hemocompatibility, which is a positive sign for future applications.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074201","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":"Single-Pass System to Characterize the Effects of Blood Species and Hematocrit on Flow-Induced Hemolysis.","authors":"Sailahari V Ponnaluri, Moustafa Meki, Luke H Herbertson, Qijin Lu, Brent A Craven, Richard A Malinauskas","doi":"10.1111/aor.70005","DOIUrl":"https://doi.org/10.1111/aor.70005","url":null,"abstract":"<p><strong>Background: </strong>To assess hemolysis potential, blood pump developers frequently perform in vitro testing in accordance with the ASTM F1841 standard. However, options in test parameters such as blood species, anticoagulant, and blood collection and preparation methods can lead to inconsistent hemolysis results.</p><p><strong>Methods: </strong>To improve in vitro hemolysis test sensitivity and characterize the impact of species and hematocrit (HCT) on flow-induced hemolysis, a pressure-driven, single-pass micro-nozzle test system with short blood exposure times was developed. To compare different blood species, porcine, bovine, ovine, and human blood pools were adjusted to 35% HCT, and 2.7 mL blood aliquots were pneumatically injected at different flow rates through two converging nozzle tips with diameters of 250 and 410 μm. Plasma-free hemoglobin (pfHb) concentration was measured to assess hemolysis after passing through the nozzle tip model. Additionally, porcine blood was tested at 25%, 35%, and 45% HCT using the 410 μm nozzle.</p><p><strong>Results: </strong>Using a single blood source, the repeatability for a single nozzle and reproducibility based on five separate nozzles were characterized. Results for the nozzles were consistent, with coefficients of variation of 0.5% for flow rate and less than 16% for pfHb levels. Hemolysis increased markedly with flow rate for all species, with pfHb levels being lowest for ovine and bovine blood and highest for human blood. Additionally, hemolysis increased non-linearly with increasing HCT.</p><p><strong>Conclusion: </strong>The nozzle tip model can be used to examine other blood factors that impact hemolysis and to support and advance computational fluid dynamics hemolysis simulations.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940436","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":"A Novel Numerical Study on the Development and Implementation of a Physiological Control Strategy for HeartMate 3 LVAD.","authors":"Amin Khorshid Savar, Fang Chen, Yunzhang Cheng","doi":"10.1111/aor.15052","DOIUrl":"https://doi.org/10.1111/aor.15052","url":null,"abstract":"<p><strong>Purpose: </strong>With the rising prevalence of heart disease and the limited availability of heart transplants, the demand for Left Ventricular Assist Devices (LVADs) is growing. While LVADs significantly improve the quality of life for heart failure patients, conventional models operate at a fixed speed, failing to adapt to varying blood flow demands. The Power Ratio Control (PRC) method offers a promising approach to adjusting blood flow according to activity levels dynamically, improving LVAD adaptability. This research investigates the application of PRC to enhance LVAD performance.</p><p><strong>Method: </strong>To the best of our knowledge, this study presents the first implementation of PRC on the HeartMate 3. We also develop a model to incorporate clinically relevant parameters and peripheral components into an advanced model. This framework simulates real-world conditions, integrating dynamic factors like preload, contractility, and heart rate variations to evaluate the device's performance.</p><p><strong>Results: </strong>Results show that PRC significantly improves HeartMate 3's dynamic response to physiological changes, allowing it to mimic the behavior of a healthy heart closely. Under PRC, the LVAD achieves better fluid responsiveness, stable cardiac output (CO), and efficient adaptation to varying activity levels. These findings highlight the potential clinical benefits of PRC, offering a more personalized approach to heart failure management.</p><p><strong>Conclusion: </strong>This research represents a significant advancement in LVAD technology, pioneering the use of PRC in the HeartMate 3 and enhancing modeling accuracy. These innovations underscore the potential for adaptive control strategies to improve LVAD performance, paving the way for broader future advancements in mechanical circulatory support.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940443","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":"Integration of Vasculature Network in Organoids.","authors":"Maria C Beyer","doi":"10.1111/aor.70003","DOIUrl":"https://doi.org/10.1111/aor.70003","url":null,"abstract":"<p><p>Utilizing findings discovered by a handful of research groups, including those at the University of Michigan, researchers in Beijing have synthesized native blood vessels in organoid tissue.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940411","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}