{"title":"Aortic Pulse Wave Velocity and Extracellular Water Expansion in Hemodialysis Patients.","authors":"Roohi Chhabra, Andrew Davenport","doi":"10.1111/aor.15015","DOIUrl":"https://doi.org/10.1111/aor.15015","url":null,"abstract":"<p><strong>Background: </strong>Pulse wave velocity (PWV), a measurement of arterial stiffness, is a risk factor for cardiovascular mortality in hemodialysis patients. Debate continues as to whether PWV is increased by volume overload. As such, we reviewed the association between volume overload and PWV.</p><p><strong>Methods: </strong>We measured aortic PWV (aPWV) in hemodialysis patients attending routine dialysis sessions with contemporaneous measurements of extracellular water/total body water (ECW/TBW) ratios using multifrequency bioimpedance.</p><p><strong>Results: </strong>A total of 102 patients, 63.7% male, mean age 63.5 ± 15.9 years, 44.1% diabetic, median dialysis duration 22.2 (4.9-52.8) months, weight 73.7 ± 15.8 kg, and central systolic blood pressure 157 ± 35 mmHg had a mean aPWV of 10.1 ± 2.5 m/s. Patients dialyzed with a low dialysate calcium (median 1.0 [1.0-1.25] mmol/L). Patients with aPWV of ≥ 10 m/s were older (72.9 ± 10.3 vs. 52.6 ± 14.4 years, p < 0.01) with a higher ECW/TBW ratio (40.6 ± 1.3 vs. 39.6 ± 1.7, p < 0.001), with no differences in active vitamin D<sub>3</sub> or calcium-containing medications. Aortic PWV was associated with age (r = 0.9, p < 0.001) and ECW/TBW (r = 0.33, p = < 0.001), and after adjusting aPWV for age, ECW/TBW remained higher (40.5 ± 1.5 vs. 39.5 ± 1.5, p < 0.001). On multivariable testing, ECW/TBW remained independently associated with a raised aPWV (odds ratio [OR] 1.59 (95% confidence intervals [CI] 1.06-2.41), p = 0.026), and after age adjustment (OR 1.74 (95% CI 1.19-2.53, p = 0.004)).</p><p><strong>Conclusions: </strong>This study highlights the association between volume overload, as determined by bioimpedance in hemodialysis patients, and arterial stiffness measured by aPWV. These results would reinforce the importance of improving volume control in hemodialysis patients to reduce cardiovascular risk.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960482","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}
Kirill Pozhar, Boris Putrya, Nikita Zhilo, Koushik Guha, Sergey Selishchev
{"title":"Automation of Ultrafiltration Rate Control by Glucose Concentration Regulation in Peritoneal Dialysis Solution.","authors":"Kirill Pozhar, Boris Putrya, Nikita Zhilo, Koushik Guha, Sergey Selishchev","doi":"10.1111/aor.15019","DOIUrl":"https://doi.org/10.1111/aor.15019","url":null,"abstract":"<p><strong>Background: </strong>Glucose absorption into the bloodstream and body tissues poses a significant challenge in peritoneal dialysis, resulting in a reduced ultrafiltration rate and requiring the use of a dialysate with a high initial glucose concentration. The goal of the presented study is to develop a system for controlling glucose concentration and ultrafiltration rate.</p><p><strong>Methods: </strong>The paper proposes a method for the automatic control of glucose infusion to maintain a given glucose concentration and ultrafiltration rate. This method utilizes an optical glucose monitor and a control strategy that combines feedback with prediction of peritoneal volume. Computer simulations were conducted to evaluate the efficiency of the method under various conditions, including errors in the glucose monitor, inaccuracies in parameter determination, and drift in patient parameters. Additionally, the method was compared to an open loop.</p><p><strong>Results and conclusions: </strong>Our results demonstrate the feasibility of using noninvasive glucose monitoring systems and the proposed control strategy to maintain a given dialysate glucose concentration. The proposed closed loop provides more stable maintenance of glucose concentration and ultrafiltration rate for at least 12 h, even in the presence of significant glucometer errors, compared to continuous glucose infusion.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966216","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":"Investigating M101's Effect in Improving Cardiac and Diaphragmatic Mechanical and Functional Properties on Wistar Rat.","authors":"Ollivier Grimault, Michael Theron, Quentin Boete, Mathieu Maalouf, Jean-Baptiste Quéméneur, Franck Zal, Karelle Léon, Karine Pichavant-Rafini","doi":"10.1111/aor.15014","DOIUrl":"https://doi.org/10.1111/aor.15014","url":null,"abstract":"<p><strong>Background: </strong>The critical importance of effective oxygen delivery during organ preservation to prevent ischemia-reperfusion injury has been reported in the literature. Moreover, traditional preservation methods often fail to meet oxygenation needs, prompting research into alternatives like hemoglobin-based oxygen carriers (HBOCs) such as M101 provided by HEMARINA. This extracellular hemoglobin, derived from Arenicola marina, shows a high affinity for oxygen and delivers it through a physiological gradient under hypoxic conditions.</p><p><strong>Methods: </strong>In this context, the mechanical and functional properties of the heart and diaphragm muscles from Wistar rats were evaluated in the presence of M101.</p><p><strong>Results: </strong>The experiments showed that M101-treated hearts maintained higher contraction amplitudes, heart rates, and coronary flow over time compared to controls, indicating improved functional stability. Furthermore, the M101-treated diaphragm exhibited prolonged contraction and relaxation times, with significant improvements in contraction amplitude at higher stimulation frequencies. Finally, the Burke index revealed reduced fatigue in the M101-treated group compared to the controls.</p><p><strong>Conclusions: </strong>These findings suggest that M101 significantly enhances the mechanical and functional properties of both tested muscles under experimental conditions. Further research is warranted to unravel these findings and explore clinical applications.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143959934","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":"Influence of Preoperative Anatomical Characteristics on the Direction of Inflow Cannula in HeartMate 3.","authors":"Shusuke Imaoka, Daisuke Yoshioka, Shunsuke Saito, Takuji Kawamura, Ai Kawamura, Ryohei Matsuura, Yusuke Misumi, Koichi Toda, Shigeru Miyagawa","doi":"10.1111/aor.15018","DOIUrl":"https://doi.org/10.1111/aor.15018","url":null,"abstract":"<p><strong>Background: </strong>The influence of inflow cannula (IC) direction in HeartMate 3 (HM3) remains unclear. We investigated preoperative anatomical characteristics related to IC direction by analyzing computed tomography (CT) images and assessed the relationship between prognosis and IC direction in HM3.</p><p><strong>Methods: </strong>We evaluated 48 patients who underwent HM3 implantation and categorized them based on the IC direction: anterior/lateral wall (group A, n = 18), mitral/aortic valve (B, n = 21), and posterior/inferior wall (C, n = 9). In preoperative CT, the positional relationship between the mitral valve, left ventricle (LV) apex, chest wall, and diaphragm was evaluated. The survival rate and freedom rate from complications after HM3 implantation in each group were evaluated.</p><p><strong>Results: </strong>On preoperative CT, group A had a higher mitral valve height from the LV apex than group B (68 ± 13 and 52 ± 14 mm, respectively; p < 0.01). Group C had a longer distance between the LV apex and chest wall than group B (20 ± 9 and 9 ± 6 mm, p < 0.01). Group C had a shorter thoracic depth from the LV apex than did group B (24 ± 9 and 39 ± 11 mm, p < 0.01). The 3-year survival rates after HM3 implantation for groups A, B, and C were 88%, 90%, and 100%, respectively. The rates of freedom from complications after HM3 implantation at 3 years in groups A, B, and C were 50%, 43%, and 20%, respectively.</p><p><strong>Conclusions: </strong>The IC direction in HM3 was influenced by the preoperative position of the mitral valve, LV apex, chest wall, and diaphragm. The IC direction in HM3 did not significantly affect survival rates.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960629","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}
Margaux Navez, Nicholas Gilbo, Morgan Vandermeulen, Tiago Pinto Coelho, Pauline Erpicum, Marc Gilbert Lagny, Clarisse Malisoux, Claire Guarin, Gabriel Thierry, Pierre Delanaye, Etienne Cavalier, François Jouret, Olivier Detry
{"title":"Simultaneous Ex Situ Normothermic Perfusion of Paired Kidneys in Pigs.","authors":"Margaux Navez, Nicholas Gilbo, Morgan Vandermeulen, Tiago Pinto Coelho, Pauline Erpicum, Marc Gilbert Lagny, Clarisse Malisoux, Claire Guarin, Gabriel Thierry, Pierre Delanaye, Etienne Cavalier, François Jouret, Olivier Detry","doi":"10.1111/aor.15016","DOIUrl":"https://doi.org/10.1111/aor.15016","url":null,"abstract":"<p><strong>Background: </strong>Normothermic Machine Perfusion (NMP) is essential in renal transplantation to improve organ viability before transplantation. This study presents a proof of concept for simultaneous ex situ perfusion of paired porcine kidneys using exogenous creatinine and iohexol clearances to assess renal function, with the primary objective of examining intra-individual differences.</p><p><strong>Methods: </strong>Five kidney pairs (n = 10) were harvested from pigs, preserved at 4°C for 3 h, and subjected to 6-h NMP. Each pair was perfused with a solution containing red blood cells, and perfusion parameters were monitored continuously. Biochemical parameters were assessed using hourly perfusate and urine samples. Kidney function was evaluated using creatinine, which was introduced during the priming procedure.</p><p><strong>Results: </strong>No significant differences were observed between paired kidneys in terms of perfusion and biochemical parameters. Both kidneys maintained stable mean arterial pressures (67.40 ± 12.08 mmHg for right vs. 71.50 ± 4.36 mmHg for left) and flows (68.90 ± 38.61 mL/min vs. 54.00 ± 26.08 mL/min), with consistent electrolyte balance and pH levels. The high inter-individual variability in perfusion and biochemical parameters underscores the importance of paired comparisons.</p><p><strong>Conclusions: </strong>This pig model of simultaneous NMP of paired kidneys demonstrates that the intra-individual variance is low, which makes it possible to test treatments prior to kidney transplantation using one kidney as a valid comparator of the other.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960551","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}
Thomas Stieglitz, Ines Bersch, Natalie Mrachacz-Kersting, Cristian Pasluosta
{"title":"Differences and Commonalities of Electrical Stimulation Paradigms After Central Paralysis and Amputation.","authors":"Thomas Stieglitz, Ines Bersch, Natalie Mrachacz-Kersting, Cristian Pasluosta","doi":"10.1111/aor.15017","DOIUrl":"https://doi.org/10.1111/aor.15017","url":null,"abstract":"<p><strong>Background: </strong>Patients with spinal cord injury (SCI) or with severe brain stroke suffer from life-lasting functional and sensory impairments. Other traumatic injuries such as limb loss after an accident or disease also affect motor function and sensory feedback and impair quality of life in those individuals. Invasive and non-invasive functional electrical stimulation (FES) is a well-established method to partially restore function and sensory feedback of paralyzed and phantom limbs. It is also a supporting technology for the rehabilitation of the neuromuscular system and for complementing assistive devices.</p><p><strong>Methods: </strong>This work reviews the current state-of-the-art of FES as a technology for restoring function and supporting rehabilitation therapy and assistive devices.</p><p><strong>Results: </strong>Electrodes, electrical stimulation, use of brain signals for rehabilitation and control, and sensory feedback are covered as parts of the whole. A perspective is given on how clinical and research protocols developed for patients with SCI and brain injuries can be translated to the treatment of patients with an amputation and vice versa. We further elaborate on how motor learning strategies with quantitative electrophysiological and kinematic measurements may help caregivers in the rehabilitation process. Insights from practitioners (collected during a workshop of the IFESS 2025) have been integrated to summarize common needs, open questions, and challenges.</p><p><strong>Conclusions: </strong>The information from the literature and from practitioners was integrated to propose the next steps towards establishing common guidelines and measures of FES in clinical practice towards evidence-driven treatment and objective assessments.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953133","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}
John Vandenberge, Dong Han, Wenji Sun, Shigang Wang, Douglas Tran, Nancy Kim, Kiersten Clark, Randy Perez, Bartley P Griffith, Zhongjun J Wu
{"title":"In Vitro Comparison of Device-Induced Hemolysis, Platelet Defects, and von Willebrand Factor Degradation Between the HeartMate 2 and HeartMate 3 Pumps.","authors":"John Vandenberge, Dong Han, Wenji Sun, Shigang Wang, Douglas Tran, Nancy Kim, Kiersten Clark, Randy Perez, Bartley P Griffith, Zhongjun J Wu","doi":"10.1111/aor.15013","DOIUrl":"10.1111/aor.15013","url":null,"abstract":"<p><strong>Background: </strong>Left ventricular assist devices (LVADs) have been utilized to maintain the circulatory demands of patients with end-stage heart failure. Despite their positive impact, hemocompatibility-related adverse events remain a major challenge. The aim of this study is to compare in vitro hemocompatibility performance between the HeartMate 2 (HM2) and HeartMate 3 (HM3) pumps by assessing device-induced blood damage in an in vitro circulatory loop.</p><p><strong>Methods: </strong>Fresh healthy human blood was circulated for 4 h in a circulatory loop assisted by an HM2 or HM3 pump at a flow rate of 4.5 L/min and a pressure head of 75 mmHg. Hourly blood samples were collected for analysis of hemolysis, platelet activation, platelet receptor shedding, and high molecular weight multimer (HMWM) degradation of von Willebrand factor (VWF).</p><p><strong>Results: </strong>The data from the hourly blood samples showed that the HM3 pump caused significantly lower levels of hemolysis, platelet activation, platelet receptor shedding, and HMWM degradation of VWF compared to the HM2 pump.</p><p><strong>Conclusion: </strong>The HM3 exhibited superior overall hemocompatibility to the HM2, underscoring the advantages of the fully magnetically levitated centrifugal pump design in the HM3 compared to the mechanical bearing-supported axial pump design of the HM2.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963608","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}
Paulo N. Martins, Barish H. Edil, Lacey McNally, Narendra R. Battula
{"title":"Expanding the Use of Ex Situ Organ Machine Perfusion Beyond Transplantation","authors":"Paulo N. Martins, Barish H. Edil, Lacey McNally, Narendra R. Battula","doi":"10.1111/aor.15011","DOIUrl":"10.1111/aor.15011","url":null,"abstract":"<div>\u0000 \u0000 <p>Machine perfusion preservation of grafts has become the gold standard organ preservation method. It has been developed to improve the quality of grafts due to the increasing gap between demand and supply of organs for transplantation. Following successful long-term machine perfusion preservation with automated commercial devices developed for preservation of organs for transplantation, there is increasing interest in utilizing perfused discarded human organs and xenografts for a variety of purposes beyond transplantation including gene therapy and modulation, drug testing, chemotherapy, ex vivo surgery, organ supporting systems, bioengineering, and surgical training and education. Here, we review all current and potential applications of machine perfusion preservation.</p>\u0000 </div>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":"49 8","pages":"1229-1235"},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061999","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":"Assessment of User Experience, Acceptability, Usability, Human-Device Interaction, and Ergonomics in Two Mobile FES-Cycling Systems for Individuals With Spinal Cord Injury.","authors":"Roberta Nossa, Emilia Biffi, Nicole Sanna, Eleonora Diella, Eleonora Guanziroli, Federica Ferrari, Simona Ferrante, Franco Molteni, Alessandra Pedrocchi, Marco Tarabini, Emilia Ambrosini","doi":"10.1111/aor.15007","DOIUrl":"https://doi.org/10.1111/aor.15007","url":null,"abstract":"<p><strong>Background: </strong>Functional Electrical Stimulation Assisted Cycling (FES-cycling) is a rehabilitation intervention for individuals with Spinal Cord Injury (SCI), offering benefits like increased muscle trophism, improved cardiopulmonary function, and reduced bone demineralization. Despite numerous studies on its physical advantages, few have focused on user experience. This study evaluates the user experience, usability, acceptability, and human-device interaction of two FES-cycling systems: a recumbent FES-bike prototype from Politecnico di Milano and the commercial BerkelBike Pro.</p><p><strong>Methods: </strong>We recruited 15 participants with SCI, aged 18-65, with varying injury levels. The user experience (primary outcome), acceptability, usability, human-device interaction, and ergonomics of both systems were investigated by means of 4 questionnaires: the User Experience Questionnaire (UEQ), the Technological Acceptance Measure 3 (TAM-3), the System Usability Scale (SUS), and a customized questionnaire to evaluate human-device interaction both in terms of ergonomic aspects and psychological factors.</p><p><strong>Results: </strong>The user experience received positive evaluations across all dimensions (scores ≥ 1.5 on a scale from -3 to 3), with slightly higher, though not statistically significant, scores for the FB. Secondary outcomes indicated strong acceptability (global TAM-3 scores > 5.5/7 for both devices), high usability ratings (SUS scores ≥ 75/100 for both devices), and favorable interaction and ergonomics, emphasizing ease of use, comfort, and alignment with user expectations.</p><p><strong>Conclusions: </strong>The study underscores the positive user experience as the primary outcome, along with strong acceptance and usability of both devices, emphasizing their potential to enhance Sport-Therapy and the value of integrating user perspectives in future development.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953392","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}