Artificial organs最新文献

{"title":"Recent Progress in Artificial Organs","authors":"","doi":"10.1111/aor.14968","DOIUrl":"10.1111/aor.14968","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 4","pages":"537-538"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381511","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 Escalation to CentriMag for Acute Myocardial Infarction-Induced Out-of-Hospital Cardiac Arrest With Refractory to Extracorporeal Membrane Oxygen Support.","authors":"Yi-Han Jhuang, Yi-Ting Tsai, Chih-Yuan Lin, Hung-Yen Ke, Po-Shun Hsu, Yi-Chang Lin, Hsiang-Yu Yang, Chien-Sung Tsai","doi":"10.1111/aor.14957","DOIUrl":"https://doi.org/10.1111/aor.14957","url":null,"abstract":"<p><strong>Objectives: </strong>The mortality rate of acute myocardial infarction (AMI)-related refractory cardiogenic shock (rCS) remains high, particularly in patients experiencing cardiac arrest with extracorporeal cardiopulmonary resuscitation (ECPR). This study aimed to evaluate the outcomes of early escalation to CentriMag for AMI-induced out-of-hospital cardiac arrest (OHCA) with ECPR.</p><p><strong>Methods: </strong>Patients with AMI-induced OHCA with refractory to ECMO support after ECPR were enrolled. Clinical data were analyzed to identify predictive factors for mortality and survival benefits.</p><p><strong>Results: </strong>Eighty-nine patients were enrolled, of whom 26 underwent CentriMag implantation. The 1-year survival rate for those with the implantation was 34.6%. In contrast, those without implantation showed a survival rate of 7.9%. The average time from the initiation of ECPR to CentriMag implantation was 22.5 ± 14.6 h. The surgical mortality group exhibited a larger body surface area, longer intervals from CPR to ECPR, shorter duration of CentriMag support, and higher preoperative serum creatinine and postoperative day 1 serum aspartate aminotransferase levels. A prolonged interval from CPR to ECPR was identified as an independent risk factor for mortality. Extended duration of CentriMag support was associated with improved survival outcomes.</p><p><strong>Conclusions: </strong>Early CentriMag implantation rescues patients experiencing AMI-related OHCA with rCS and refractory to ECMO support after ECPR. This intervention provides a critical time window, serving as a safe bridge to decision.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188036","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":"Sex Differences in the In-Hospital Outcomes of Left Ventricular Assist Device Implantation: A Population-Based National Inpatient Sample Study From 2015 to 2021.","authors":"Renxi Li, Deyanira J Prastein, Steven W Boyce","doi":"10.1111/aor.14965","DOIUrl":"https://doi.org/10.1111/aor.14965","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular assist device (LVAD) implantation can be used to manage advanced heart failure. Debates over sex differences in postoperative outcomes of LVAD implantation remain contentious; there is limited evidence available from the continuous-flow era, particularly following the introduction of third-generation devices. This study aimed to conduct a comprehensive, contemporary, and population-based analysis of the sex difference in the in-hospital outcomes following LVAD implantations.</p><p><strong>Methods: </strong>Patients who underwent LVAD implantation were selected from National Inpatient Sample from Q4 2015-2021. Multivariable logistic regression was used to compare in-hospital outcomes between females and males, where demographics, socioeconomic status, primary payer status, hospital characteristics, comorbidities, and transfer/admission status were adjusted.</p><p><strong>Results: </strong>There were 1201 (23.6%) female and 3881 (76.4%) male patients who underwent LVAD implantation. Females and males had comparable in-hospital mortality, MACE, and stroke. However, females had higher diaphragmatic paralysis (aOR = 7.94, 95 CI = 1.46-43.48, p = 0.02). Meanwhile, females had lower cardiogenic shock (aOR = 0.85, 95 CI = 0.73-0.98, p = 0.02), renal complications (aOR = 0.72, 95 CI = 0.62-0.84, p < 0.01), and infection (aOR = 0.70, 95 CI = 0.58-0.86, p < 0.01). Females also had longer hospital length of stay (44.1 ± 40.0 vs. 38.8 ± 30.6 days, p = 0.01) and higher total hospital charges (1293779.0 ± 1182139.0 vs. 1172780.0 ± 917544.0 US dollars, p = 0.04).</p><p><strong>Conclusion: </strong>In the contemporary era with the introduction of third-generation devices, in-hospital mortality and stroke after LVAD implantation continued to decrease and were comparable in both sexes. However, there are still notable sex-based differences in the complications of LVAD implantation, which underscores the need for sex-specific preoperative risk assessments and tailored perioperative management.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078485","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":"Long-Term Liver Machine Perfusion Preservation: A Review of Recent Advances, Benefits and Logistics","authors":"Juliana Pavan-Guimaraes,&nbsp;Lene Devos,&nbsp;Bianca Lascaris,&nbsp;Vincent E. de Meijer,&nbsp;Diethard Monbaliu,&nbsp;Ina Jochmans,&nbsp;Carlo Pulitano,&nbsp;Robert J. Porte,&nbsp;Paulo N. Martins","doi":"10.1111/aor.14941","DOIUrl":"10.1111/aor.14941","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The global shortage of suitable donor livers for transplantation has prompted efforts to expand the donor pool by using extended criteria donors. Machine preservation technology has shown promise in optimizing graft preservation and improving logistics. Additionally, it holds potential for organ repair, regeneration, therapeutic applications during extended preservation periods, and enhancing organ allocation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive literature review using PubMed, Embase, and Web of Science databases. All studies published between January 1, 2022, and February 7, 2024, that described machine perfusion preservation of livers for more than 24 h were eligible for inclusion. The findings were synthesized in a narrative review format to highlight key benefits and advancements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified eleven studies from multiple research groups, employing various techniques, devices, and preservation durations. Perfusion durations ranged from 1 to 13 days, with notable variations in protocols for long-term preservation beyond 24 h. Viability was assessed during perfusion only. No livers were transplanted. Among the reviewed studies, the introduction of a dialysis system emerged as the most effective strategy for managing waste accumulation during long-term liver perfusion. Differences were also observed in hemodynamics, oxygenation, organ chambers, supplemental regimens, and glycemic control.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Over the past two years, substantial progress has been made in refining protocols for long-term liver machine perfusion, with significant advancements in waste management, enabling successful multi-day perfusions. While these developments are promising, further research is necessary to standardize and optimize long-term perfusion protocols, establishing a reliable platform for both organ preservation and therapeutic applications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 3","pages":"339-352"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078483","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":"The Efficacy and Safety of Continuous Veno-Venous Hemodiafiltration With High Cutoff Membrane Versus High Flux Membrane in Septic Acute Kidney Injury: A Randomized Controlled Study.","authors":"Xiaowei Song, Caihong Liu, Min Zhang, Wei Wei, Letian Yang, Bo Wang, Yongxiu Huang, Guojiao Song, Fang Wang, Yingying Yang, Yuliang Zhao, Ling Zhang, Ping Fu","doi":"10.1111/aor.14963","DOIUrl":"https://doi.org/10.1111/aor.14963","url":null,"abstract":"<p><strong>Background: </strong>The application of high cutoff (HCO) membranes for continuous renal replacement therapy remains unclear in septic acute kidney injury (S-AKI) patients.</p><p><strong>Methods: </strong>S-AKI patients who received continuous veno-venous hemodiafiltration (CVVHDF) were randomly assigned to the experimental group (HCO membrane) and the control group (high flux membrane, HF membrane). Interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in serum and waste fluid were measured at 0, 2, 12, and 24 h after CVVHDF initiation and the 28-day mortality.</p><p><strong>Results: </strong>Eleven patients were randomized to the HCO group, and 9 patients in the HF group, with a mean age of 54.9 ± 3.2 years and 6 patients (30%) being female. After 24 h of treatment with CVVHDF, there were significant reductions in serum IL-6 and TNF-α concentrations in the HCO group (p = 0.001, 0.015) and HF group (p = 0.004, 0.031). The serum IL-6 reduction rate of the HCO group was significantly higher than that of the HF group (79.21% vs. 42.69%, p = 0.025), while serum TNF-α reduction rates were comparable between the 2 groups. There were no significant changes in serum albumin after 24 h using either HCO membrane (28.7 ± 1.7 g/L vs. 32.7 ± 1.6 g/L, p = 0.138) or HF membrane (29.6 ± 1.1 g/L vs. 32.6 ± 1.3 g/L, p = 0.055). The two groups had similar 24-h filter clotting rates and 28-day mortality.</p><p><strong>Conclusion: </strong>While CVVHDF with the HCO membrane and HF membrane both achieved significant reductions in serum cytokine levels, the HCO membrane was associated with a greater reduction rate in IL-6 but not in TNF-α. No difference was observed in serum albumin, mortality, or filter clotting.</p><p><strong>Trial registration: </strong>Registry number: ChiCTR2000039725.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078487","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":"Atrial and Ventricular Cannulation for Biventricular Circulatory Support With Double-Ended Centrifugal Pump: In Vitro Evaluation.","authors":"Christine R Flick, Chihiro Miyagi, Barry D Kuban, Anthony R Polakowski, Kiyotaka Fukamachi, Taiyo Kuroda, Jamshid H Karimov","doi":"10.1111/aor.14959","DOIUrl":"https://doi.org/10.1111/aor.14959","url":null,"abstract":"<p><strong>Background: </strong>In patients with biventricular heart failure, a biventricular assist device (BVAD) may be necessary for hemodynamic support. BVAD inflows can be established through cannulation of the atrial (AC) and/or ventricular (VC) chambers, but no consensus exists on optimal cannulation techniques. This study aimed to characterize BVAD performance related to cannulation types (AC and VC) using a continuous-flow total artificial heart (CFTAH) as the BVAD.</p><p><strong>Methods: </strong>Both methods of cannulation (AC and VC) were tested on a mock loop using dual pulsatile ventricles with valves (AB5000; Abiomed) paired as the native ventricles and a double-ended centrifugal pump with two volutes, CFTAH, as a BVAD. Pressures were collected at the inlet and outlets of the AB5000 (LAP, RAP, AoP, and PAP) and the CFTAH (Lin, Rin, Lout, and Rout). The left and right flows exiting the CFTAH (LPF and RPF) and total flow (TF), exiting systemic resistance, were monitored. Several heart failure conditions were simulated with adjustment of the pneumatic pressures (AB5000).</p><p><strong>Results: </strong>Trends between the AC and VC are similar where RAP, Lin, and Lout decreased, and AoP, PAP, TF, LPF, and RPF increased with increased support. The trends differ in LAP with an increase during AC as opposed to a decrease during VC. As a result, with this setup, left-right balance is more easily achieved during VC. TF is higher with AC, even though LPF and RPF are lower. This signifies the flow going through the aortic valve (TF-LPF) and pulmonary valve (TF-RPF) is higher with AC.</p><p><strong>Conclusions: </strong>The increased TF and valvular flow favored AC for introducing a CFTAH as BVAD to the native heart in these conditions.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073545","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":"Sabrina Haroon to Serve as an Associate Editor of Artificial Organs","authors":"Vakhtang Tchantchaleishvili","doi":"10.1111/aor.14962","DOIUrl":"10.1111/aor.14962","url":null,"abstract":"","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 4","pages":"535-536"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063438","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 Liver Preservation: Highlights From the International Liver Transplant Society 2024.","authors":"Felix J Krendl, Isabella Faria, Jessica Singh, Rupert Oberhuber, Paulo N Martins","doi":"10.1111/aor.14956","DOIUrl":"https://doi.org/10.1111/aor.14956","url":null,"abstract":"<p><p>The 2024 International Liver Transplantation Society (ILTS) Congress, held in Houston, Texas, brought together a dynamic, multidisciplinary community of global experts to explore and discuss cutting-edge innovations and unmet needs in liver transplantation. Key themes included liver machine perfusion and donation after circulatory death (DCD), reflecting the ongoing effort to expand the donor pool and improve transplantation outcomes. Machine perfusion technologies, including normothermic machine perfusion (NMP), hypothermic oxygenated perfusion (HOPE), and normothermic regional perfusion (NRP) have demonstrated great promise in optimizing graft quality, mitigating ischemia-reperfusion injury, and enhancing the use of marginal and DCD liver grafts. At this year's congress a total of 63 abstracts on liver machine perfusion were presented. For this report we selected all orally presented abstracts highlighting advances in organ preservation, artificial intelligence, treatments during ex-situ perfusion including cellular therapy as well as new the use of new biomarkers. Preclinical highlights included the potential of long-term NMP to sustain and regenerate grafts during extended ex-situ preservation, spontaneous defatting of steatotic grafts during LT-NMP, the delivery of regulatory T cells to enable organ-level immunomodulation and the removal of damage-associated molecular patterns from porcine DCD livers during NMP. On the clinical side, key points included the progression of HOPE to IDEAL-D Stage 4 evidence, increased transplant volumes through the application of NMP, the cost-effectiveness of NMP as well as the utilization of very old DCD donors through NRP. Collectively, these advancements mark a transition toward dynamic, data-driven, and personalized transplantation strategies. Machine perfusion remains central to optimizing grafts, expanding the pool of organs suitable for transplantation enhancing access to liver transplantation and improving outcomes for liver transplant recipients worldwide.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063434","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":"Normothermic Machine Perfusion vs. Static Cold Storage in Liver Transplantation: A Systematic Review and Meta-Analysis.","authors":"Patricia Viana, Samy Castillo-Flores, Maria M R Mora, Thamiris D D Cabral, Paulo N Martins, Michael Kueht, Isabella Faria","doi":"10.1111/aor.14960","DOIUrl":"https://doi.org/10.1111/aor.14960","url":null,"abstract":"<p><strong>Background: </strong>Normothermic machine perfusion (NMP) represents an alternative to prolong liver preservation and reduce organ discard rates. We performed an updated systematic review and meta-analysis to compare NMP with static cold storage (SCS) in liver transplantation.</p><p><strong>Methods: </strong>MEDLINE, Embase, and Cochrane were searched for randomized controlled trials (RCTs) or observational studies. Risk ratios (RR) and mean differences were calculated. p < 0.05 was considered significant. A random-effects model was applied for all outcomes.</p><p><strong>Prospero id: </strong>CRD42023486184.</p><p><strong>Results: </strong>We included 1295 patients from 5 RCTs and 6 observational studies from 2016 to 2023. 592 (45.7%) underwent NMP. A subgroup RCT analysis favored NMP for non-anastomotic strictures (RR 0.4; 95% CI 0.2, 0.9), postreperfusion syndrome (RR 0.4; 95% CI 0.27, 0.56), and early allograft dysfunction (RR 0.6; 95% CI 0.4, 0.9). NMP favored higher organ utilization rates (RR 1.1; 95% CI 1.02, 1.18). No significant differences between NMP and SCS were observed in graft survival or patient survival at 12 months, primary non-function, serious adverse events, overall biliary complications, AST, or bilirubin levels peak within the first 7 days, ICU or hospital length of stay.</p><p><strong>Conclusion: </strong>Our findings suggest that NMP is associated with lower non-anastomotic biliary stricture rates, postreperfusion syndrome, early allograft dysfunction, and higher organ utilization in the RCT subgroup analysis, without increasing adverse events.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063436","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":"Does Normothermic Machine Perfusion Still Provide an Advantage for Deceased Donor Kidney Transplantation? A Systematic Review and Preliminary Meta-Analysis.","authors":"Hunter Kauffman, Sarah Harter, Takayuki Yamamoto","doi":"10.1111/aor.14958","DOIUrl":"https://doi.org/10.1111/aor.14958","url":null,"abstract":"<p><strong>Background: </strong>Patients with end-stage renal disease often face prolonged waiting times for kidney transplants. Historically, the use of marginal kidneys was limited due to suboptimal preservation methods. Normothermic machine perfusion (NMP) preserves physiological activity during the preservation process, potentially improving graft function and viability, expanding the use of marginal kidneys. While preliminary results are promising, NMP has not yet undergone sufficient clinical trials to determine whether it offers advantages over more widely used techniques. The aim of this systematic review is to assess several outcomes between kidneys that underwent NMP compared to traditional preservation methods after kidney transplant.</p><p><strong>Methods: </strong>A systematic review was conducted following PRISMA guidelines. Randomized controlled trials, case series, and studies comparing NMP with hypothermic machine perfusion (HMP) or static cold storage (SCS) were included. The primary outcome assessed was delayed graft function (DGF). Secondary outcomes included primary non-function (PNF), acute rejection, and 1-year graft survival.</p><p><strong>Results: </strong>Eight NMP studies met the inclusion criteria. Meta-analysis showed significant differences in DGF between NMP and control (HMP or SCS) groups (OR: 0.47 [0.22, 0.99], p < 0.05). There were no significant differences between NMP and controls for PNF, acute rejection, or 1-year graft survival.</p><p><strong>Conclusions: </strong>These findings suggest that NMP yields similar adverse outcome rates compared to traditional methods. Notably, NMP could be associated with reduced rates of DGF. While NMP is a promising technique for renal allograft preservation, further randomized controlled trials are necessary to definitively establish its benefits over conventional preservation methods.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143057425","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}