Artificial organs最新文献

{"title":"Hemocompatibility and Long-Term Outcomes in HeartWare Versus HeartMate II Versus HeartMate 3: Multicenter Real-World Cohort.","authors":"Hamza H H Ben Nasir, Ahmed F A Mohammed, Omar Allham, Alish Kolashov, Yusuf Shieba, Lachmandath Tewarie, Bernd Panholzer, Ajay Moza, Assad Haneya, Rashad Zayat","doi":"10.1111/aor.70086","DOIUrl":"10.1111/aor.70086","url":null,"abstract":"<p><strong>Background: </strong>To compare overall and hemocompatibility-related outcomes across third-generation centrifugal-flow HeartMate 3 (HM3) versus second-generation axial-flow HeartMate II (HMII) and centrifugal-flow HeartWare (HVAD) in routine clinical practice.</p><p><strong>Methods: </strong>We conducted a multicenter observational cohort of adult LVAD recipients (n = 327: HVAD n = 112, HMII n = 142, HM3 n = 73). Baseline characteristics and perioperative variables were recorded. Overall survival was analyzed using Kaplan-Meier and Cox proportional hazards models with HM3 as reference. Hemocompatibility-related adverse events (HRAE; pump thrombosis, ischemic stroke, major bleeding) were assessed with cumulative incidence functions (Aalen-Johansen) and Fine-Gray competing-risk regression with death as a competing event; the hemocompatibility score (HCS) summarized event burden over follow-up.</p><p><strong>Results: </strong>HM3 demonstrated superior long-term survival compared with both HMII and HVAD in Kaplan-Meier analyses (log-rank p < 0.001); this advantage persisted in multivariable Cox models. HRAE-free survival was also higher with HM3 on competing-risk analysis, driven by substantially lower pump thrombosis and fewer ischemic strokes relative to HMII and HVAD. Bleeding burden did not differ materially between devices, consistent with a class effect of continuous-flow support. LDH-based hemolysis markers and HCS distributions further favored HM3. Perioperative course and general postoperative complications were otherwise broadly comparable across devices.</p><p><strong>Conclusions: </strong>In this real-world, multicenter cohort, HM3 was associated with better overall survival and a lower thromboembolic burden than HMII and HVAD, while bleeding risk remained similar. These findings support preferential selection of HM3 when device choice is feasible, and emphasize the need for targeted strategies to mitigate hemostatic complications across all LVADs.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"580-589"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145899094","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":"Age as a Surrogate for Hormonal Status and Outcomes of Women on Left Ventricular Assist Device Support: An EUROMACS Analysis.","authors":"Isabell A Just, Julia Stein, Nikolaos Cholevas, Nicolas Merke, Evgenij Potapov, Volkmar Falk, Theo M M H de By, Jan Gummert, Bart Meyns, Felix Schoenrath","doi":"10.1111/aor.70063","DOIUrl":"10.1111/aor.70063","url":null,"abstract":"<p><strong>Background: </strong>Sex differences in outcomes of patients on left ventricular assist devices (LVAD) have been reported with conflicting results. Female hormonal status affects vascular integrity and cardiac remodeling. As menopausal transition is complex and individually variable, we used age as a surrogate for hormonal status and compared outcomes in younger and older women with age-matched men.</p><p><strong>Methods: </strong>Data from 5.275 patients from the EUROMACS registry were screened. Women < 40 years (31.0 ± 6.3 years, n = 142, surrogate premenopausal) and > 60 years (65.5 ± 3.7 years, n = 256, surrogate postmenopausal) were included, while women aged 40-60 years were excluded to avoid misclassification during the perimenopausal transition. For comparison, 2138 age-matched males were included. The primary outcome was survival, with transplantation and weaning as competing risks. Secondary outcomes were defined as adverse events and length of intensive-care-unit stay.</p><p><strong>Results: </strong>Young women were more likely to present in cardiogenic shock before LVAD implantation (INTERMACS level1-2: 65.6% vs. 45.4%, p = 0.022). Within four years, young women had higher rates of weaning, transplantation and survival (weaning:sHR 1.58, 95% CI 0.73-3.4, p = 0.248; transplant: sHR2.93, 95% CI 1.86-4.61, p < 0.001; survival:sHR 2.25, 95% CI 1.48-3.41; p = 0.001). Major adverse events were more frequent in older women (bleeding: RR2.53, 95%-CI 1.7-3.8, p < 0.001; infection: RR1.43, 95% CI 1.2-1.8, p < 0.001). Comparable differences were observed in age-matched males.</p><p><strong>Conclusions: </strong>Outcomes differed between age groups, but not consistently between sexes within the same age group, suggesting age rather than sex or menopausal status driving outcome differences. These descriptive findings support equitable consideration of LVAD therapy irrespective of sex.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"590-600"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572877","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":"Innovative Herbal-Based Decellularization of Pericardium for Advanced Polymeric Skin Substitutes.","authors":"Azadeh Nochalabadi, Mozafar Khazaei, Sepideh Kadivarian, Leila Rezakhani","doi":"10.1111/aor.70087","DOIUrl":"10.1111/aor.70087","url":null,"abstract":"<p><strong>Introduction: </strong>Tissue engineering has opened new horizons with the introduction of biological scaffolds obtained by decellularization techniques as novel tools in regenerative medicine. Chemical agents such as SDS, although effective in cell removal, can cause cytotoxicity. Herbal agents can be a safer and more biocompatible alternative. This study aimed to investigate the efficacy of Acanthophelium extract (ACP) as a herbal agent in decellularization of sheep pericardium and compare it with SDS for use in skin engineering.</p><p><strong>Methods: </strong>Pericardial tissues were decellularized with different concentrations of ACP (5, 7.5% and 10%) and SDS (1%), as well as the combination of ACP + SDS. Tissue staining, biocompatibility (MTT), hemolysis, blood clotting index (BCI), scanning electron microscopy (SEM), ATR-FTIR spectroscopy, mechanical testing, contact angle, and antibacterial activity were performed.</p><p><strong>Results: </strong>Complete cell removal was observed in the ACP + SDS combination groups, while the ECM structure was preserved. Biocompatibility was more than 90% in all groups. ACP-based scaffolds had less hemolysis, a more favorable coagulation index, preserved protein structure, higher porosity, and higher hydrophilicity. Although the mechanical properties were slightly reduced, they remained acceptable. The 10% ACP + 0.1% SDS group reported the highest antibacterial effect.</p><p><strong>Conclusions: </strong>ACP extract, as a plant agent in pericardial decellularization, has an effective and biocompatible function, and in combination with a small amount of SDS, it can provide a balanced scaffold with desirable properties for skin engineering.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"530-542"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892031","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":"Impact of 2018 Donor Heart Allocation Policy Change on Patients on Biventricular Support: A UNOS Database Analysis.","authors":"Daler Rahimov, Nayeem Nasher, Tomoki Sakata, T Reese Macmillan, Christopher D Pritting, J Eduardo Rame, Rene J Alvarez, Keshava Rajagopal, John W Entwistle, Vakhtang Tchantchaleishvili","doi":"10.1111/aor.70047","DOIUrl":"10.1111/aor.70047","url":null,"abstract":"<p><strong>Background: </strong>In the United States, the donor heart allocation policy change in October 2018 granted high priority to patients on temporary mechanical circulatory support (MCS), positively influencing their pre-transplant outcomes with reduced waitlist time. However, the impact of this policy change on patients requiring biventricular support remains undetermined.</p><p><strong>Methods: </strong>We analyzed data from the United Network for Organ Sharing (UNOS) database from May 2013 to March 2024. Patients with biventricular assist devices (BiVADs), including temporary or durable devices, and total artificial hearts (TAHs) were included. The cohort was divided into two groups based on listing: before and after policy change groups. Waitlist and post-transplant survival were compared between both groups.</p><p><strong>Results: </strong>Patients on biventricular support comprised 1.5% (611/39 829) of all waitlisted candidates, and 2.6% (732/28 643) of all isolated heart transplants. There was a significantly lower prevalence of biventricular support after the policy change in both waitlisted candidates (Pre: 2.0% versus Post: 1.2%, p < 0.001) and at the time of transplantation (Pre: 3.1% versus Post: 2.1%, p < 0.001). Following the policy change, there was a significantly lower median waitlist time (Pre: 88 [29-190] days versus Post: 22 [7-69] days, p < 0.001), and a higher proportion of transplanted patients (Pre: 65% versus Post: 85%, p < 0.001). Both waitlist survival (p < 0.001) and post-transplant survival (p = 0.05) improved after the policy change.</p><p><strong>Conclusions: </strong>The 2018 policy revision was associated with a decline in biventricular support utilization in both waitlisted and transplanted cohorts. This shift corresponded with shorter waitlist durations, more frequent transplants, and better waitlist and post-transplant survival.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"601-609"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145628011","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":"Early-Stage Feasibility Testing of a Nutating Disc for Innovative Cardiovascular Applications.","authors":"Gretel Monreal, Steven C Koenig, Joshua G Crane, Mark S Slaughter, David M Lancisi, Robert Mastromattei, Richard K Wampler","doi":"10.1111/aor.70051","DOIUrl":"10.1111/aor.70051","url":null,"abstract":"<p><strong>Background: </strong>Magvad LLC is developing an innovative total artificial heart (TAH) based on a single nutating (nonrotating, \"wobbling\") disc pump design to provide up to 8 L/min pulsatile flow at 100 mmHg pressure in children and adults with end-stage heart failure (HF). We present an early-stage in vitro study to demonstrate proof-of-concept of a nutating disc mechanism for future cardiovascular applications.</p><p><strong>Methods: </strong>A commercially available single nutating disc water meter (Recordall, Badger Meter 25-3/4″) was modified and connected to a motor via a shaft coupler and controlled via software to regulate disc \"wobbles\" per minute. The nutating disc pump was integrated into static and HF-tuned dynamic mock loops and operated at shaft rotational speeds of 25-225 rpm.</p><p><strong>Results: </strong>Pressure-flow (H-Q) curves demonstrated the pump generated 7 L/min flow at 100 mmHg (225 rpm). Pump flow, motor work, hemodynamic work, and pump efficiency increased with increasing wobble speed. The pump restored hemodynamics in the dynamic HF mock loop by increasing mean arterial flow and pressure, augmenting pulsatility, and decreasing venous pressure with increasing wobble speed.</p><p><strong>Conclusions: </strong>These results demonstrate proof-of-concept and very early-stage feasibility of a single nutating disc to function as a novel low-speed volume displacement pulsatile flow mechanism for future cardiovascular applications including the development of an innovative TAH.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"625-630"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534346","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 Analysis of Pressure Drop (Δp): Hemodynamic Performance of Three Commercial Oxygenators During Cardiopulmonary Bypass.","authors":"Jan Turra, Martina Habermehl, Thomas Schiepp, Peter Rose, Berthold Klein, Benjamin Scheerer, Matthias Karck, Christoph Lichtenstern, Riesterer David Max, Dania Fischer","doi":"10.1111/aor.70088","DOIUrl":"10.1111/aor.70088","url":null,"abstract":"<p><strong>Backround: </strong>The membrane oxygenator is a critical component of extracorporeal circulation (ECC), whose performance directly depends on its structural architecture. Differences in fiber geometry and winding patterns lead to variable hemodynamic pressure conditions. The resulting pressure drop Delta p (Δp) across the oxygenator module is a decisive indicator for system load and the risk of blood trauma. The aim of this study is the comparative analysis of the Δp of three commercial oxygenators: Medtronic Affinity Fusion, Eurosets A.L. ONE Plus, and LivaNova Inspire 8F, calculated from the difference between inlet and outlet pressure.</p><p><strong>Methods: </strong>This prospective observational study included 60 patients divided into three groups of 20 patients each, based on the type of oxygenator used in their perfusion circuit.</p><p><strong>Results: </strong>The results of the study show that the Δp value was significantly higher for the Inspire 8F compared to the Affinity Fusion and A.L. ONE Plus oxygenators. Between measurement points T2 and T11, the highest Δp was 116 ± 56 mmHg for the Medtronic group, 123 ± 26 mmHg for the Eurosets group, and 168 ± 33 mmHg for the Inspire 8F group. No significant differences in Δp were observed between the Affinity Fusion and the A.L. ONE Plus at any measurement point.</p><p><strong>Conclusion: </strong>The results of the study show that the Inspire has the highest Δp of all the oxygenators examined in this study. In addition to potential influencing factors, the value is also dependent on the internal structure and the surface properties of the oxygenators. However, the present study does not help to clarify the effects of the pressure before and after the oxygenator or the Δp itself on hemolysis and subsequent clinical parameters associated with the use of different commercially available oxygenators.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"564-571"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145997214","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":"Non-Invasive Monitoring of Transcatheter Heart Valve Using Photoplethysmography and Machine Learning.","authors":"Silvia Puleo, Gianluca Diana, Chiara Livolsi, Lorenzo Nioi, Nicola Cuscino, Francesco Scardulla, Salvatore Pasta, Leonardo D'Acquisto","doi":"10.1111/aor.70069","DOIUrl":"10.1111/aor.70069","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) has become the preferred treatment for aortic stenosis in the elderly. However, the durability of transcatheter heart valves (THV) and the risk of leaflet thrombosis preclude the extension of TAVI in young people. This study sought to formulate a proof-of-concept solution for non-invasive, continuous monitoring of THV function using photoplethysmography (PPG) sensors and machine learning models. An in vitro mock circulatory loop was developed using a compliant aortic phantom and an implanted self-expanding Evolut FX device. Two PPG sensors were attached to the phantom surface to record flow signals during various hemodynamic scenarios generated by Latin Hypercube Sampling. Endoscopic imaging measurements of the geometric orifice area (GOA) were used to assess valve performance. PPG-derived metrics and flow variables were used to train regression and classification models that predicted healthy versus decreased leaflet motion. The regression model showed an R² of 0.83, RMSE of 7.18 mm², and MAE of 5.58 mm². The classifier correctly identified reduced leaflet motion (95% accuracy, 0.89 precision, and 0.91 recall). This study demonstrates the efficacy of PPG sensors and machine learning for non-invasive THV monitoring. The approach offers a promising tool for early detection of leaflet dysfunction, thereby improving the management of TAVI patients.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"543-549"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145628003","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":"Three Ventricular Assist Devices (True TriVAD) as Bridge to Durable Biventricular Support (BiVAD) in LVAD Patient With Severe Aortic Regurgitation.","authors":"Nikolaos Cholevas, Felix Schoenrath, Nicolas Merke, Denis Fries, Marcus Mueller, Johanna Mulzer, Evgenij Potapov","doi":"10.1111/aor.70072","DOIUrl":"10.1111/aor.70072","url":null,"abstract":"<p><p>A Left Ventricular Assist Device (LVAD) patient developed severe aortic regurgitation (AR), leading to right heart failure and multi-organ dysfunction (MOD). Temporary Right Ventricular Assist Device (tRVAD) support caused left ventricle (LV) overload and pulmonary edema. Implantation of an Impella 5.5 successfully unloaded the LV and stabilized the patient, enabling durable RVAD implantation with surgical aortic valve replacement (SAVR). The case highlights the importance of early AR recognition and tailored mechanical circulatory support.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"631-635"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646955","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":"Optimizing Prolonged (6 h) Normothermic Machine Perfusion of Donor Kidneys (PROPER Study).","authors":"Asel S Arykbaeva, Veerle A Lantinga, L Leonie van Leeuwen, Marten Engelse, Ton J Rabelink, Jesper Kers, Jason B Doppenberg, Volkert A L Huurman, Robert A Pol, Robert C Minnee, Henri G D Leuvenink, Rutger J Ploeg, Cyril Moers, Dorottya K de Vries, Ian P J Alwayn","doi":"10.1111/aor.70080","DOIUrl":"10.1111/aor.70080","url":null,"abstract":"<p><strong>Background: </strong>Ex situ normothermic machine perfusion (NMP) holds great promise in preserving and concomitantly evaluating the viability of kidney grafts. NMP for 1 to 2 h has been shown to be feasible and safe, demonstrating no adverse impact on early graft function. Prolonging the duration of NMP offers an extended timeframe for evaluation, besides creating a window for pretransplant therapeutical interventions. This study aimed to assess the feasibility of extending the duration of perfusion to 6 h.</p><p><strong>Methods: </strong>We investigated the prerequisites to extend the warm perfusion of donor kidneys safely for up to 6 h. Human donor kidneys deemed unsuitable for transplantation were included for experimental NMP. Throughout the perfusion process, we assessed metabolic activity, as well as the extent of biochemical, hemolytic, and histological injury through biopsy, urine, and perfusate analyses. Stepwise alterations were made to the protocol accordingly.</p><p><strong>Results: </strong>An analysis of 30 discarded kidneys revealed that improvements in erythrocyte quality, oncotic pressure, and correction of electrolyte imbalances facilitated the achievement of steady flow volumes and ensured a favorable macroscopic appearance of the graft. Extending the perfusion period to 6 h displayed preserved renal viability and stable histological characteristics.</p><p><strong>Conclusions: </strong>The presented protocol shows prolonging NMP of donor kidneys to 6 h is feasible. We have implemented pivotal elements including the use of fresh (≤ 7 days) washed red blood cells, the addition of albumin, and urine recirculation, resulting in a stable and balanced perfusion. Ongoing refinements are necessary to enable the clinical application of a more prolonged NMP.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":"550-563"},"PeriodicalIF":2.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145877708","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":"Predictors of Brain Infarction in Pediatric Patients During Extracorporeal Membrane Oxygenation.","authors":"Riccardo Iacobelli, Thomas Fux, Sara Wood Schalling, Sarah Kopfer, Jonas Berner, Alexander Fletcher-Sandersjöö, Lars Mikael Broman","doi":"10.1111/aor.70115","DOIUrl":"https://doi.org/10.1111/aor.70115","url":null,"abstract":"<p><strong>Introduction: </strong>Brain infarction (BI) is a severe complication of extracorporeal membrane oxygenation (ECMO) with high morbidity and mortality. We aimed to determine the incidence of BI and identify predictors in pediatric patients receiving ECMO.</p><p><strong>Methods: </strong>We performed a retrospective single-center cohort study including patients aged 29 days to < 18 years who underwent ECMO treatment at a tertiary center between January 2010 and October 2023. The primary outcome was BI during ECMO. Predictors of BI were analyzed using logistic regression.</p><p><strong>Results: </strong>Among 179 included patients, BI was diagnosed in 51 (28%). Multivariable logistic regression identified venoarterial (VA) ECMO (OR 3.82, 95% CI 1.45-10.08; p = 0.007) and higher pre-ECMO arterial lactate (per mmol/L increase, OR 1.11, 95% CI 1.02-1.20; p = 0.01) as independent predictors of BI. The 30-day mortality was 67% among patients with BI compared with 15% among those without BI (p < 0.001).</p><p><strong>Conclusion: </strong>Brain infarction was more common than in most prior reports and was associated with high short-term mortality. VA ECMO mode, compared with venovenous ECMO, and higher pre-ECMO arterial lactate were independent predictors of BI. These findings support enhanced, standardized neurological monitoring and a liberal early brain CT strategy in pediatric ECMO patients, particularly those supported with VA ECMO.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147525816","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}