Artificial organs最新文献

{"title":"The Warm Revolution: A Meta-Analysis of DCD Versus DBD Liver Transplant Outcomes in the Normothermic Machine Perfusion Era","authors":"Patricia Viana,&nbsp;Luiz Gustavo Albuquerque Mello de Oliveira,&nbsp;Maria Meritxell Roca Mora,&nbsp;Aghnia J. Putri,&nbsp;Michael Kueht II,&nbsp;Paulo N. Martins,&nbsp;Devin Eckhoff,&nbsp;Isabella Faria","doi":"10.1111/aor.70180","DOIUrl":"10.1111/aor.70180","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Donation after circulatory death (DCD) livers have historically been associated with higher early allograft dysfunction rates, ischemic cholangiopathy, and graft loss when compared with donation after brain death (DBD) donors. Normothermic machine perfusion (NMP) emerged as a strategy to optimize graft preservation. This study aims to assess whether outcomes differ between DCD and DBD liver grafts preserved using NMP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a systematic review and meta-analysis of MEDLINE, Embase, and Cochrane databases, including randomized controlled trials (RCTs) and observational studies comparing DCD and DBD grafts undergoing NMP. Pooled analyses were performed using random-effects models with risk ratios (RR) and mean differences. Significance was set at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighteen studies and 1578 livers were included, with 51.4% DCD grafts. Compared to DBD grafts, DCD grafts had significantly lower organ utilization (RR 0.84, <i>I</i>² = 62.1%, <i>p</i> &lt; 0.001) but higher rates of biliary interventions (RR 2.48, <i>I</i>² = 0.0%, <i>p</i> = 0.008). No significant differences were observed in the incidence of non-anastomotic or anastomotic biliary strictures, post-reperfusion syndrome, early allograft dysfunction, primary non-function, acute kidney injury, ICU or hospital stay, hepatic laboratory parameters, or graft and patient survival at 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>DCD liver transplantation with NMP achieves outcomes comparable to DBD grafts across major clinical endpoints, including biliary complications, allograft function, and survival. However, these findings apply to a selected subgroup of DCD grafts that meet viability criteria during perfusion. Moreover, DCD grafts were more frequently subjected to biliary procedures without being associated with increased complication rates. Ultimately, DCD grafts had lower organ utilization rates than DBD, even in the setting of machine perfusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1396-1406"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148325836","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":"Extending Preservation in Pediatric Kidney Transplantation: First Contemporary Experience With Hypothermic Oxygenated Machine Perfusion","authors":"Gionata Spagnoletti,&nbsp;Evaldo Favi,&nbsp;Alberto Mauro,&nbsp;Alberto Maria Fratti,&nbsp;Riccardo Cirelli,&nbsp;Marta Maistri,&nbsp;Andrea Cappoli,&nbsp;Raffaella Labbadia,&nbsp;Antonio Gargiulo,&nbsp;Marco Busutti,&nbsp;Isabella Guzzo,&nbsp;Marco Spada","doi":"10.1111/aor.70196","DOIUrl":"10.1111/aor.70196","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hypothermic machine perfusion currently represents the gold standard preservation modality for kidneys retrieved from adult deceased donors, with reduced delayed graft function (DGF) rates and improved early transplant survival compared to static cold storage (SCS). To date, clinical experience with hypothermic oxygenated machine perfusion (HOPE) in pediatric kidney transplants (KT) setting remains extremely limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a single-center retrospective analysis of pediatric KT recipients preserved using HOPE. Between November 2019 and December 2023, 129 pediatric kidney transplants were performed at our institution. After exclusion of living donor transplants (<i>n</i> = 37), 92 recipients were included: 40 grafts preserved using HOPE and 52 using SCS. Clinical outcomes, graft function, and survival were compared between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study cohort consisted mainly of male (59.8%), with a mean recipient age of 12.6 ± 5.9 years. Baseline donor and recipient characteristics were comparable between groups. Despite a significantly longer total cold preservation time (CPT) in the HOPE group (23.7 ± 4.1 vs. 13.3 ± 3.7 h; <i>p</i> &lt; 0.001), no significant differences were observed in the incidence of DGF, biopsy-proven acute rejection, postoperative length of stay, or graft function up to 1 year. One-year death-censored graft survival was 97% in the HOPE group and 98% in the SCS group, with no significant difference between preservation strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this first clinical experience with HOPE in pediatric KT, oxygenated hypothermic perfusion proved to be safe and feasible, even in the setting of prolonged CPT. The implementation of HOPE programs could improve the logistical management of pediatric donors and recipients without compromising transplant results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1418-1426"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673004","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":"Post-Market Analysis of the Xenios Console With the Xlung Tubing Kit 230 for Extracorporeal Membrane Oxygenation After Cardiac Surgery","authors":"Luca Conci,&nbsp;Anne-Kristin Schaefer,&nbsp;Thomas Schlöglhofer,&nbsp;Emilio Osorio-Jaramillo,&nbsp;Amila Kahrovic,&nbsp;Alvaro Perazzo,&nbsp;Marcus Granegger,&nbsp;Daniel Zimpfer,&nbsp;Dominik Wiedemann,&nbsp;Julia Riebandt","doi":"10.1111/aor.70194","DOIUrl":"10.1111/aor.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The use of veno-arterial extracorporeal membrane oxygenation (V-A ECMO) has led to an increasing number of devices available on the market. Most studies pay less attention to which devices have been used; therefore, the information on performance for each device is limited. The current study is a comprehensive post-market analysis of all the major functions and adverse events rates of the Xenios console and XLung kit 230 preconfigured ECMO tubing set in post-cardiotomy applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective, single-center analysis, conducted between 2017 and 2021, included 47 adult patients who received V-A ECMO support using the Xenios system following cardiac surgery at our institution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Xenios device was found to effectively improve and maintain microcirculation, organ perfusion, gas exchanges, organ function support, and stabilization of the cardiocirculatory system, while maintaining pump performance and stable body core temperature. Device-related adverse events occurred in 28% of patients but resolved in 81% of cases without leaving clinical sequelae. Fewer hemolysis events than reported in the literature were recorded. Every patient experienced at least two patient-related adverse events, but 43% had no relation to the device and 45% resolved without permanent damage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The performance of the evaluated device was demonstrated in all key clinical areas, with an adequate safety profile.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1464-1475"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444189","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":"An Optimized Multi-Stage Drainage Cannula Design for Venoarterial Extracorporeal Membrane Oxygenation","authors":"Avishka Wickramarachchi,&nbsp;Mehrdad Khamooshi,&nbsp;Aidan Burrell,&nbsp;Shaun D. Gregory","doi":"10.1111/aor.70203","DOIUrl":"10.1111/aor.70203","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Venoarterial extracorporeal membrane oxygenation (VA ECMO) is a life-saving therapy that provides cardiorespiratory support for cardiogenic shock patients. But, due to altered flow dynamics induced by VA ECMO drainage cannulas, complications such as thrombosis and hemolysis are common. Therefore, this study aimed to develop an optimized drainage cannula design with reduced complication risk using computational fluid dynamics (CFD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The multi-objective optimization process entailed generating a response surface based on a design of experiments with <i>n</i> = 540 unique cannula designs. Minimizing pressure drop, maintaining &gt; 100 mm/s tip velocity, and minimization of average wall shear stress were assigned as objective functions. The optimized design was then tested in three patient-specific geometries using CFD and compared against a clinically available model (Maquet).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final design consisted of three rows of five side holes, with all side holes titled at an angle of 31.5°. When compared to the Maquet model, the optimized cannula generated lower stagnant blood volumes, increased cannula tip velocities (&gt; 300 mm/s), and increased drainage from the upper body.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The optimized cannula developed in this study demonstrated favorable flow dynamics that may increase flow and reduce the risk of life-threatening complications including thrombosis and hemolysis when translated to a clinical setting, thereby improving VA ECMO patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1372-1383"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/aor.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148519807","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":"A High Granularity Machine Learning Model to Predict Successful Weaning During V-V ECMO","authors":"Sukethram Sivakumar,&nbsp;Leon Fan,&nbsp;Mingfeng Cao,&nbsp;Patricia Brown,&nbsp;Bo Soo Kim,&nbsp;Glenn J. R. Whitman,&nbsp;Sung-Min Cho,&nbsp;HERALD Investigators","doi":"10.1111/aor.70198","DOIUrl":"10.1111/aor.70198","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Weaning from venovenous extracorporeal membrane oxygenation (V-V ECMO) remains unstandardized due to limited literature, with delayed weaning increasing the risk of vascular injury and multi-organ failure. We aim to assess whether high-granularity data, involving longitudinal ECMO, physiological, respiratory, and hemodynamic electronic medical record (EMR) variables, can predict V-V ECMO weaning outcomes and outperform the Respiratory ECMO Survival Prediction (RESP) score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of adult V-V ECMO patients (≥ 18 years) at Johns Hopkins Hospital from 2016 to 2024. Machine learning (ML) models were developed using the RESP score alone (Model A) and EMR time-series data across four intervals: pre-ECMO, first 24 h, last 24 h before decannulation, and full ECMO run (Models B-E). Random Forest, CatBoost, AdaBoost, and XGBoost algorithms were trained using 80/20 train-test splits. Feature importance was assessed using Shapley Additive Explanations (SHAP) values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>119 V-V ECMO patients (median age = 48%, 59.6% female) were included, with 62 (52.1%) experiencing mortality at discharge. Model E attained the highest performance with an area under the receiver operating characteristic curve (AUROC) of 0.904; Models A-D achieved AUROCs of 0.815, 0.715, 0.515, and 0.881 respectively. SHAP analysis identified Body Mass Index (BMI), pulse, SpO₂, and immunocompromised status as key features in predicting weaning success. BMI and pulse were strongest in the first 24 h, whereas age was most influential pre-ECMO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>High-granularity ML models accurately predicted V-V ECMO weaning, with BMI, age, and immunocompromised status as key predictors. Their superior performance against RESP score-based ML models suggests clinical utility for V-V ECMO weaning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1453-1463"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444204","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":"Upcoming Meetings","authors":"","doi":"10.1111/aor.70240","DOIUrl":"https://doi.org/10.1111/aor.70240","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149072541","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":"Structural Optimization Design and Experimental Study of Centrifugal Blood Pump Impeller","authors":"Qing Han,&nbsp;Xuemin Liu,&nbsp;Jiejie Shao,&nbsp;Peng Wang,&nbsp;Honghua Zhao","doi":"10.1111/aor.70208","DOIUrl":"10.1111/aor.70208","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>As a core component of mechanical circulatory support devices, a centrifugal blood pump with excessively low hydraulic efficiency can lead to poor blood compatibility, low efficiency, excessive heat generation, insufficient blood supply, and pressure fluctuations. These issues adversely affect patient prognosis. To address these bottlenecks, this study aims to perform structural optimization of the centrifugal blood pump with the goal of improving hydraulic efficiency and exploring suitable optimization methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study takes the UJN-1 magnetically suspended centrifugal blood pump as the research object, with hydraulic efficiency simulated by computational fluid dynamics (CFD) as the target, and compares the results of optimizing four impeller parameters (blade inlet angle, outlet angle, number of blades, blade height) using orthogonal experiments and neural network-genetic algorithm (NN-GA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetic algorithm (GA) optimization yielded an impeller with 20.48° inlet angle, 17.22° outlet angle, 6 blades, and 4.55 mm height. Its hydraulic efficiency increased by 2.38%, outlet pressure fluctuation decreased significantly, and it outperformed the orthogonal pump by 1.57%. Hydraulic experiments validated the results, with deviations within approximately ±1% of CFD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NN-GA demonstrates superior global optimization capabilities to the orthogonal experiment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Significance</h3>\u0000 \u0000 <p>This study provides new insights for multi-parameter coupled centrifugal blood pump optimization and guides pump design in energy, chemical, and semiconductor industries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1476-1486"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787732","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 High-Speed Image AI Facilitating the Visual Assessment of the Membrane's Motion in EXCOR VAD","authors":"Hidehito Ota,&nbsp;Takuya Kawahara,&nbsp;Miki Ohta,&nbsp;Satoshi Kodera,&nbsp;Hironori Ebishima,&nbsp;Fumiaki Shikata,&nbsp;Ryo Inuzuka,&nbsp;Yasutaka Hirata,&nbsp;Hikoro Matsui","doi":"10.1111/aor.70167","DOIUrl":"10.1111/aor.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Visual assessment of membrane motion is essential for managing EXCOR VAD, but accuracy depends on observer experience. We evaluated a high-speed image AI model to support healthcare providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients on EXCOR Pediatric admitted to the University of Tokyo Hospital (May 2022–May 2024) were included. Membrane images were obtained from patients and a manually filled pump at bench. An image recognition model was trained to estimate membrane position. Experienced physicians (<i>N</i> = 11) and inexperienced physicians (<i>N</i> = 11) assessed pump status in a sample dataset (<i>N</i> = 12) with and without AI assistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 142 movies from five patients were collected (98 training, 45 validation), plus 1100 bench images for training. Model accuracy was 0.91, with AUROCs of 0.99 (“fill”) and 0.96 (“empty”). Among experienced physicians, accuracy significantly improved with AI assistance from 0.83 (0.67–0.88) to 0.92 (0.92–1.0) (median (IQR); <i>p</i> = 0.016). Among inexperienced physicians, accuracy also significantly improved with AI assistance from 0.67 (0.5–0.75) to 0.83 (0.75–0.92) (<i>p</i> = 0.049).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A high-speed image AI can facilitate the visual assessment of EXCOR VAD by healthcare providers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1434-1442"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147939948","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":"Large-Eddy Simulation of the FDA Benchmark Blood Pump: Validation Against Experiments and Implications for Turbulent Flow Mechanisms","authors":"Xuanming Huang,&nbsp;Chi Ding,&nbsp;Yujie Sun,&nbsp;Shidi Huang,&nbsp;Andrea Cioncolini,&nbsp;Damiano Padovani,&nbsp;Ju Liu","doi":"10.1111/aor.70190","DOIUrl":"10.1111/aor.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study presents a systematic validation and comparative assessment of computational fluid dynamics (CFD) strategies for centrifugal blood pump simulations using the US Food and Drug Administration benchmark model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scale-resolving large eddy simulation (LES) with transient sliding-interface (SI) coupling is evaluated and compared against Reynolds-averaged Navier–Stokes (RANS) approaches employing both multiple reference frame and SI formulations. Numerical predictions are validated through direct comparison with particle image velocimetry measurements under two representative operating conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results indicate that LES with transient rotor-stator coupling achieves consistently improved agreement with experimental velocity fields compared with RANS-based methods, particularly in the diffuser region where strong intermittency and wall-bounded turbulence are present. In contrast, RANS-based approaches exhibit noticeable discrepancies in these regions. A mesh sensitivity study and an assessment of temporal averaging effects are conducted for LES. The quality of the LES results is further quantified using three complementary metrics, demonstrating that a mesh resolution of approximately 80 million cells achieves a well-resolved LES regime. Building on the validated scale-resolving simulations, detailed analyses of vortical structures, turbulent kinetic energy distributions, and velocity energy spectra are performed to characterize the internal flow physics of the pump. The results reveal the central role of transient vortex dynamics in turbulence generation within centrifugal blood pumps.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overall, this study demonstrates that scale-resolving, transient simulation approaches are essential for accurately capturing the highly unsteady, turbulence-dominated flow features in ventricular assist devices and provides practical guidance for future high-fidelity hemodynamic and hemocompatibility studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1346-1359"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366793","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 Perfusion Preservation as a Platform for Advanced Liver Surgery","authors":"Patricia Viana,&nbsp;Michael Irby,&nbsp;Narendra R. Battula,&nbsp;Maheshwaran Pitchaimuthu,&nbsp;Barish Edil,&nbsp;Ajay Jain,&nbsp;Claire Goumard,&nbsp;Olivier Scatton,&nbsp;Paulo N. Martins","doi":"10.1111/aor.70209","DOIUrl":"10.1111/aor.70209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To review the role of machine perfusion in complex in situ and ex situ liver resections and its potential to improve perioperative and oncologic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary Background Data</h3>\u0000 \u0000 <p>Complex liver resections requiring prolonged vascular exclusion are limited by ischemia reperfusion injury and postoperative liver failure. Machine perfusion, established in liver transplantation to enhance organ preservation and functional assessment, is increasingly applied to advanced hepatobiliary surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A narrative review of experimental and clinical studies evaluating hypothermic and normothermic machine perfusion in in situ and ex situ liver surgery was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Current evidence indicates that machine perfusion is feasible and safe in complex liver resections, allowing prolonged vascular control while preserving liver function. Early clinical reports demonstrate improved postoperative recovery and successful oncologic resections, with emerging transplant data suggesting a potential reduction in tumor recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Machine perfusion may expand the boundaries of complex liver surgery by mitigating ischemia reperfusion injury and enabling otherwise unresectable procedures. Prospective studies are required to define optimal perfusion strategies and long term oncologic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"50 10","pages":"1335-1345"},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648329","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}