Artificial organs最新文献

{"title":"Percutaneous Intervention in External Outflow Graft Obstruction of Magnetically Levitated Left Ventricular Assist Device: Long-Term Follow-Up and Quality of Life.","authors":"Anna Huang, Julia Stein, Vanessa I T Zwaans, Carla L Schuering, Gaik Nersesian, Christoph Hoermandinger, Markus Müller, Johanna Mulzer, Stephan Dreysse, Philipp Stawowy, Christoph T Starck, Joerg Kempfert, Evgenij V Potapov, Volkmar Falk, Leonhard Wert","doi":"10.1111/aor.70144","DOIUrl":"https://doi.org/10.1111/aor.70144","url":null,"abstract":"<p><strong>Objectives: </strong>External compression of the outflow graft causing obstruction (eOGO) is a potentially lethal complication in patients on long-term mechanical circulatory support with the HeartMate 3 (HM3, Abbott) left ventricular assist device (LVAD). This complication results from the build-up of gelatinous substance between the bend relief and outflow graft and can be resolved by percutaneous intervention, surgery, or transplantation. This single-centre follow-up study evaluated the suitability of percutaneous intervention as a treatment strategy and long-term outcomes of eOGO patients in terms of laboratory, LVAD, and quality-of-life parameters.</p><p><strong>Methods: </strong>On October 31, 2024, a search of the implantation centre's electronic database identified HM3 patients diagnosed with eOGO. Individual patient data concerning 31 cases was analyzed. A quality-of-life survey was conducted using the short version of the Kansas City Cardiomyopathy Questionnaire (KCCQ-12).</p><p><strong>Results: </strong>The patient cohort had a median support time to eOGO diagnosis of 1219 days [976, 1917] and a post-treatment follow-up of 686 days [447, 1003]. 64.5% of patients (n = 20) underwent percutaneous intervention showing immediate LVAD flow improvement of 0.5 L/min post-intervention (p = 0.04). Of eight post-interventional survey respondents, 62.5% (n = 5) were assigned a fair-excellent health status according to the KCCQ-12.</p><p><strong>Conclusions: </strong>Percutaneous intervention is a suitable treatment strategy for eOGO, resolving low flow and providing satisfactory long-term quality of life outcomes. Given the increasing eOGO incidence after 1 year of support and overall mortality of 29.0%, clinicians should remain on high alert for this complication. We suggest computed tomography (CT) imaging be considered early on when eOGO is suspected.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760146","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":"Validation of Aortic Blood Flow Simulations During Extracorporeal Circulation Using Phase Contrast Magnetic Resonance Imaging.","authors":"Anna Kathrin Assmann, Sinje Reimers, Jonah S Schrauder, Lei Qu, Xiangge Yin, Amir Moussavi, Artur Lichtenberg, Susann Boretius, Michael Neidlin, Alexander Assmann","doi":"10.1111/aor.70136","DOIUrl":"https://doi.org/10.1111/aor.70136","url":null,"abstract":"<p><strong>Objectives: </strong>Although extracorporeal circulation (ECC) is routinely used in invasive cardiovascular medicine and can cause severe complications, the impact of ECC on arterial blood flow is not yet fully understood. This study aims to reveal actual bloodflow profiles during different ECC scenarios.</p><p><strong>Methods: </strong>Twenty-three New Zealand White rabbits underwent ECC by ante- (n = 7) or retro-grade (n = 9) or physiological perfusion (n = 7). Arterial blood flow profiles were assessed with a focus on cerebral and visceral perfusion. Numerical simulation models were tuned and validated based on magnetic resonance imaging (MRI).</p><p><strong>Results: </strong>Ante- and retrograde ECC resulted in completely divergent aortic blood flow patterns. Supraaortic and visceral perfusions were not impaired during ante- or retro grade ECC. Excellent correlation of volume flow rates was achieved between MRI and simulations (r = 0.98). Intima damage was observed in regions of high wall shear stress (WSS).</p><p><strong>Conclusions: </strong>This is the first study assessing arterial blood flow during different ECC scenarios in a living organism, and additionally validating precise blood flow simulations by in vivo measurements. Retrograde ECC does not a priori impair cerebral perfusion. Individualized simulations may guide cannulation strategies aiming at minimization of ECC-related complications.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760120","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":"Evaluation of Bleeding Rates With Sodium Bicarbonate Versus Heparin-Based Purge Solutions for Impella CP and 5.5 Ventricular Assist Devices.","authors":"Priya J Patel, Jesse E Harris, Kevin R Donahue, Ju H Kim, Mariah I Sigala","doi":"10.1111/aor.70145","DOIUrl":"https://doi.org/10.1111/aor.70145","url":null,"abstract":"<p><strong>Background: </strong>Sodium bicarbonate-based purge solution (BBPS) is a growing alternative to heparin-based purge solution (HBPS). However, literature comparing the safety of BBPS to HBPS remains limited. We assessed the safety of HBPS to BBPS in patients with Impella devices by evaluating the rates of major and clinically relevant non-major bleeding (CRNMB).</p><p><strong>Methods: </strong>This is a single-center, retrospective cohort study including patients on Impella CP or 5.5 devices maintained on HBPS or BBPS for ≥ 48 h. The primary outcome was a composite of major bleeding and CRNMB. Secondary endpoints included suspected device thrombosis and systemic complications.</p><p><strong>Results: </strong>A total of 83 patients met inclusion criteria (48 in the HBPS and 35 in BBPS). There was no difference in the composite incidence of major bleeding and CRNMB between HBPS and BBPS (56.3% vs. 45.7%, p = 0.34) or the incidence of device-related or systemic complications. However, there was a significantly higher incidence of major bleeding in those with an Impella 5.5 receiving HBPS as compared to BBPS (27.3% vs. 4.8%, p = 0.04).</p><p><strong>Conclusion: </strong>BBPS may be a safer option in those requiring longer duration of Impella support even in the absence of contraindications to heparin use and offers comparable efficacy to HBPS. The use of BBPS may be a solution towards standardizing and simplifying anticoagulation management in this population. Larger studies are needed to support the durability of Impella devices with BBPS.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760891","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":"Comparison of Intraoperative Doppler Flow Measurements and Algorithmic Flow Estimations in Patients Undergoing Durable Left Ventricular Assist Device Implantation.","authors":"Gaik Nersesian, Anna Stegmann, Daniel Lewin, Yuriy Hrytsyna, Leonard Pitts, Julius Kaemmel, Marian Kukucka, Alexander Mladenow, Lisa Garczarek, Julia Stein, Friedrich Kaufmann, Volkmar Falk, Evgenij Potapov, Pia Lanmueller","doi":"10.1111/aor.70150","DOIUrl":"https://doi.org/10.1111/aor.70150","url":null,"abstract":"<p><strong>Introduction: </strong>Left ventricular assist devices (LVAD) have become an established therapy for end-stage heart failure over the last three decades. In currently available devices, the blood flow is estimated using a power consumption algorithm. In this study, intraoperative direct LVAD flow measurement with an ultrasonic flow probe was analyzed.</p><p><strong>Methods: </strong>As part of our routine evaluation of optimal LVAD flow, intraoperative direct flow measurement at the outflow graft was performed using a 14-mm ultrasonic flow probe. Direct LVAD flow measurements were performed at different speed levels: 4400 rpm, 4800 rpm, 5200 rpm, and the optimal flow setting before chest closure. In twenty consecutive patients who underwent a durable LVAD implantation via median sternotomy in our institution between January and April 2025, direct flow measurement was compared with the estimated flow provided by the device.</p><p><strong>Results: </strong>Median age was 63 [60;68] years, 17 (85%) were male, 8 (40%) had a history of acute myocardial infarction. Temporary mechanical circulatory support with a microaxial flow pump was necessary in 8 (40%) patients prior to durable LVAD implantation. Destination therapy was indicated in 12 (60%) cases. Mean flows at 4400 rpm were 2.9 ± 0.3 and 3.4 ± 0.4 L/min calculated by the pump and measured by the probe, respectively. Mean difference between the measurements was 0.56 L/min (95% CI [0.40, 0.70], p < 0.001). Mean flows at 4800 rpm were 3.5 ± 0.3 and 4.1 ± 0.5 L/min, respectively. Mean difference between the measurements was 0.55 L/min (95% CI [0.33, 0.77], p < 0.001). Mean flows at 5200 rpm were 4.2 ± 0.3 and 4.7 ± 0.5 L/min, respectively. Mean difference between the measurements was 0.53 L/min (95% CI [0.40, 0.70], p = 0.001). Mean optimal speed for patients was 5400 rpm, mean difference between the measurements was 0.49 L/min (95% CI [0.23, 0.74], p = 0.001).</p><p><strong>Conclusion: </strong>LVAD flow measured with an ultrasonic flow probe shows significantly higher results (approximately +0.5 L/min) compared to the flow estimated by the device. The difference remains constant at different LVAD speed modes. Intraoperative flow measurement employing an ultrasonic flow probe is a valuable tool for hemodynamic evaluation during implantation of a durable LVAD.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760869","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":"Identification of Coagulation Phenotypes Using Viscoelastic and Conventional Assays During Veno-Venous Extracorporeal Membrane Oxygenation: A Hierarchical Clustering Analysis.","authors":"Daisuke Irimada, Yudai Iwasaki, Yusuke Takei, Moe Oyama, Ami Tanaka, Shinichi Yamaguchi, Naoya Kobayashi, Daisuke Konno, Takuya Shiga, Masanori Yamauchi","doi":"10.1111/aor.70153","DOIUrl":"https://doi.org/10.1111/aor.70153","url":null,"abstract":"<p><strong>Background: </strong>Veno-venous extracorporeal membrane oxygenation (V-V ECMO) is essential for managing severe respiratory failure; however, hemorrhagic and thrombotic complications remain major challenges. Conventional activated partial thromboplastin time (APTT) monitoring may inadequately reflect the complex coagulation changes during ECMO. Although viscoelastic hemostatic assays (VHAs) provide a comprehensive assessment, discrepancy patterns between VHAs and conventional tests in V-V ECMO patients remain unclear.</p><p><strong>Objectives: </strong>This study aimed to identify distinct coagulation phenotypes in patients receiving V-V ECMO using hierarchical clustering of VHA and conventional coagulation parameters.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at a tertiary university hospital in Japan. Patients receiving V-V ECMO between November 2020 and June 2023 who underwent VHA and conventional coagulation testing were included. Coagulation profiles were clustered using hierarchical analysis of five variables. Cluster validity was assessed, and results were visualized using principal component analysis and generalized additive models.</p><p><strong>Results: </strong>A total of 19 patients and 110 VHA measurements were analyzed. Three distinct coagulation phenotypes were identified. Cluster 1 demonstrated concordant prolongation of APTT and citrated kaolin reaction time (CK-R). Clusters 2 and 3 exhibited disproportionately prolonged CK-R relative to APTT, with Cluster 3 further characterized by elevated fibrinogen and platelet counts. Anticoagulant use, laboratory markers, and clinical outcomes, including thrombotic and bleeding events, were evaluated. Complication rates did not differ significantly among clusters.</p><p><strong>Conclusions: </strong>Hierarchical clustering identified three distinct coagulation profiles among V-V ECMO patients, highlighting the heterogeneity of ECMO-related coagulopathy. Thromboelastography-derived CK-R may complement APTT monitoring to inform more tailored anticoagulation strategies in this population.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760944","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":"Incidence and Management of Access Site Infection Following Trans-Axillary Implant of a Microaxial Left Ventricular Assist Device.","authors":"Junichi Shimamura, Nolberto Jaramillo, Gabrielle Amar, Igor Laskowski, Sateesh Babu, Romeo Mateo, Arun Goyal, Steven Lansman, Avi Levine, Abhay Dhand, David Spielvogel, Suguru Ohira","doi":"10.1111/aor.70146","DOIUrl":"https://doi.org/10.1111/aor.70146","url":null,"abstract":"<p><strong>Background: </strong>The Impella 5.5 is microaxial left ventricular assist device (LVAD) implanted most commonly into the axillary artery (AxA). This study aims to investigate the incidence and management of vascular graft infection (VGI) following circulatory support with the Impella 5.5.</p><p><strong>Methods: </strong>This is a single-center retrospective analysis of 92 patients who were supported by Impella 5.5 between June 2020 and August 2024. Since November 2023, Dacron graft has been tunneled through the pectoralis major muscle via a separate incision in patients expected to require prolonged support. The graft was trimmed and buried beneath the pectoralis major muscle during explant. Support period was classified as short (≤ 14 days, Group SS) or extended (> 14 days, Group ES).</p><p><strong>Results: </strong>Of the 92 patients, 26 (28.3%) died while on support, Impella was explanted in 66 patients (71.7%): Bridge-to-recovery in 36 (39.1%), bridge-to-durable LVAD in 8 (8.7%), and bridge-to-transplant in 22 (23.4%) including 5 heart and kidney transplant (HKT). Median support duration was 7 [5, 8] days in Group SS (N = 54) and 27.5 [18, 38] days in Group ES (N = 38). No infections were reported in Group SS. Four patients in Group ES who underwent HKT experienced VGI following 39, 47, 51, and 85 days of support. Two patients with tunneled grafts required patch repair of AxA, while the remaining two patients with non-tunneled grafts required extensive extra-anatomical bypass.</p><p><strong>Conclusion: </strong>Approximately 10% of patients requiring extended support developed VGI. Heart transplant recipients with a high risk of infection such as extended support or HKT will benefit from a comprehensive approach for early diagnosis and therapeutic intervention.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721421","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":"Metabolic Conditioning for Renal Protection During Cardiopulmonary Bypass: A Narrative Review.","authors":"Youssef El Dsouki, Patrick Hallak, Ignazio Condello, Roberto Lorusso","doi":"10.1111/aor.70133","DOIUrl":"https://doi.org/10.1111/aor.70133","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute kidney injury (AKI) remains one of the most frequent and prognostically relevant complications following cardiac surgery, even in the era of modern cardiopulmonary bypass (CPB) management and goal-directed perfusion. Cardiac surgery-associated AKI (CSA-AKI) is associated with increased postoperative morbidity, prolonged hospitalization, neurocognitive complications, and reduced early as well as long-term survival. Although optimization of macrocirculatory parameters and oxygen delivery has demonstrated benefits, renal injury often occurs despite apparently adequate perfusion and oxygenation. Recent evidence suggests that CPB-related metabolic stress and protein catabolism contribute to renal vulnerability. Indeed, intravenous amino acid administration has emerged as a novel metabolic strategy for renal protection.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;This narrative review was informed by a structured literature search of PubMed/MEDLINE, Embase, and the Cochrane Library, covering publications from database inception through March 2025. Search terms included combinations of \"acute kidney injury,\" \"cardiac surgery,\" \"cardiopulmonary bypass,\" \"amino acids,\" \"intravenous amino acid infusion,\" \"renal protection,\" and \"goal-directed perfusion\". Randomized controlled trials, meta-analyses, systematic reviews, secondary analyses, and relevant narrative reviews published in English were considered. Particular emphasis was placed on high-quality evidence, including the PROTECTION randomized trial, contemporary meta-analyses, and consensus or expert reviews addressing cardiac surgery-associated acute kidney injury and perioperative metabolic interventions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The literature search identified 124 records; 18 articles were included in the final narrative synthesis after title, abstract, and full-text evaluation. The selected literature comprised a multicenter randomized controlled trial, secondary analyses of randomized data, meta-analyses/systematic reviews, narrative or expert reviews, and observational or mechanistic studies addressing CSA-AKI. The evidence indicates that CSA-AKI results from an interaction between altered renal perfusion, inflammation, ischemia-reperfusion injury, and CPB-induced metabolic derangement. Intravenous amino acid infusion was consistently associated with reduced postoperative AKI incidence, particularly in patients with preexisting chronic kidney disease, without significant safety concerns. These findings support amino acid administration as a metabolic adjunct to goal-directed perfusion rather than a standalone intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Intravenous amino acid infusion is a recent strategy to reduce AKI in cardiac surgery. By targeting the CPB-induced metabolic stress, amino acid administration complements goal-directed perfusion and expands current AKI prevention paradigms beyond hemodynamic optimization alone. Future research ","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728116","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":"From Rescue to Risk: Challenges and Controversies in Pushing the Boundaries of Organ Utilization by Machine Perfusion.","authors":"Damiano Patrono, Rebecca Panconesi, Nicola De Stefano, Renato Romagnoli","doi":"10.1111/aor.70148","DOIUrl":"https://doi.org/10.1111/aor.70148","url":null,"abstract":"<p><p>The ongoing shortage of donor livers has prompted the use of extended criteria donors (ECD) and the development of ex-situ machine perfusion (MP) to expand the transplantable organ pool. MP has transformed liver transplantation (LT) by improving preservation, enabling better logistics, and allowing real-time viability assessment that is, a process aimed at predicting liver function after transplantation based on MP parameters. Although viability assessment has been proposed to safely expand donor pool and improve LT outcomes, it remains inconsistent. This article will summarize currently available assessment protocols and recapitulate studies exploring emerging viability biomarkers, discussing the need for an operational definition of viability assessment and its implications for the design of future studies on the subject.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727943","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":"Condensation in a Membrane Oxygenator Analyzed by Bronchoscopy and Ultrasonography.","authors":"Shin-Ichiro Nagao, Kazumasa Orihashi","doi":"10.1111/aor.70143","DOIUrl":"https://doi.org/10.1111/aor.70143","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the mechanism of condensation-related oxygenator dysfunction (CROD) and explore preventive strategies, we directly visualized the interior of a membrane oxygenator using bronchoscopy and ultrasonography and evaluated the effect of external warming.</p><p><strong>Methods: </strong>The CROD model consisted of a circuit incorporating a membrane oxygenator perfused with water at 3 L/min and supplied with gas (50% O₂ in air) at 2 L/min. The hollow fiber bundle was observed bronchoscopically at the outlet surface and ultrasonographically from the lateral aspect. The percentage droplet area was quantified. In a heating model, the oxygenator was externally warmed with circulating 39°C water. Changes in droplet area, gas-supply pressure, and outlet-surface temperature were analyzed. A single experiment was conducted for each model.</p><p><strong>Results: </strong>In the CROD model, condensation appeared at approximately 2 h, predominantly in the cooler outer zone. The droplet area increased over time and showed a strong positive association with gas-supply pressure (r = 0.9041). Gas flushing partially reduced both parameters but did not restore baseline values. Ultrasonographic findings remained similar to those of a dry oxygenator. In the heating model, the outer zone was approximately 1°C warmer than the inner zone, and no visible condensation developed over 24 h, with stable gas pressure.</p><p><strong>Conclusions: </strong>Two-directional visualization demonstrated that outlet-surface condensation, mainly in the outer zone, was associated with elevated gas-supply pressure in this mechanistic model of CROD. Uniform external heating suppressed condensation, suggesting that temperature control and early detection may represent practical strategies to mitigate CROD.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721776","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":"Comparative Hemolytic Effects of Ex Vivo Lung Perfusion Perfusates: An In Vitro Blood Loop Approach.","authors":"Chris H H Chan, Asma F Farooqui, Christopher Tan, Wilson Lim, Brian Quach, Gabriel Loor, Yaxin Wang","doi":"10.1111/aor.70138","DOIUrl":"https://doi.org/10.1111/aor.70138","url":null,"abstract":"<p><strong>Background: </strong>Ex vivo lung perfusion (EVLP) enables transplant physicians to assess and optimize donor lung quality, thereby expanding the donor pool and improving clinical outcomes. However, elevated hemolysis and lactate accumulation within the EVLP perfusate may compromise graft viability.</p><p><strong>Methods: </strong>The primary goal of this study was to evaluate the hemocompatibility of two cellular perfusates-whole blood (WB) and leukocyte-depleted blood (LD)-using identical mock EVLP loops. Saline-washed red blood cells (RBC) were included as an additional background reference perfusate. All perfusates were filtered and diluted to a hematocrit of 19.1% ± 1.3% and circulated for 10 h at 37°C with a flow rate of 2.7 ± 0.2 L/min.</p><p><strong>Results: </strong>Over the course of in vitro blood circulation, the rates of increase in hemolysis and lactate levels were significantly higher in the WB group than in the LD and RBC groups (p < 0.05), with no significant differences observed between LD and RBC. The normalized index of hemolysis at 10 h was significantly greater in the WB group compared with LD (p < 0.01) and RBC (p < 0.05).</p><p><strong>Conclusions: </strong>These findings suggest that, in blood-based ex vivo perfusion, leukocyte depletion is associated with reduced hemolysis and lactate accumulation. In addition, a simple yet promising in vitro blood loop approach can be used to evaluate perfusate quality and improve EVLP outcomes.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147727908","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}