Artificial organs最新文献

{"title":"Engineering Immune-Protective Stem Cell-Derived β-Cell Grafts for Type 1 Diabetes: Encapsulation Technologies and the Emerging Graft Ecosystem.","authors":"Mansuor A Alanazi","doi":"10.1111/aor.70245","DOIUrl":"https://doi.org/10.1111/aor.70245","url":null,"abstract":"<p><strong>Background: </strong>Stem cell-derived β-cell replacement has emerged as a promising strategy for the treatment of type 1 diabetes (T1D), potentially addressing the limitations of exogenous insulin therapy and donor-dependent islet transplantation. However, despite substantial progress in stem cell differentiation and transplantation technologies, long-term graft survival remains constrained by immune rejection, recurrent autoimmunity, fibrosis, hypoxia, and inadequate vascularization. Encapsulation technologies have therefore become central to the development of clinically viable bioartificial pancreas systems.</p><p><strong>Methods: </strong>This review examines advances in stem cell-derived β-cell replacement, with particular emphasis on encapsulation technologies and their translational challenges. Major stem cell sources, including embryonic stem cells and induced pluripotent stem cells, contemporary differentiation strategies, and clinical progress were evaluated. Microencapsulation, macroencapsulation, and conformal coating approaches were critically considered with respect to immunoprotection, mass transport, retrievability, and long-term graft functionality. Biological barriers and emerging engineering strategies were further integrated within a unified mechanistic framework.</p><p><strong>Results: </strong>Current evidence indicates that successful long-term β-cell replacement is limited not only by immune-mediated injury but also by foreign body responses, pericapsular fibrosis, hypoxia, inadequate vascular integration, and compromised mass transport. Emerging approaches, including oxygen-generating biomaterials, immunomodulatory encapsulation systems, vascularization-promoting platforms, smart responsive biomaterials, and gene-edited hypoimmune β-cells, are being developed to overcome these barriers. Collectively, these advances indicate that durable graft function requires coordinated regulation of immunity, oxygenation, vascularization, and tissue homeostasis rather than the generation of functional insulin-producing cells alone.</p><p><strong>Conclusions: </strong>Durable β-cell replacement for T1D will likely require engineering a supportive graft ecosystem rather than focusing exclusively on cell replacement. The field is consequently transitioning from cell replacement engineering toward graft ecosystem engineering, in which stem-cell engineering, biomaterials science, immune modulation, vascularization strategies, and biosensing technologies are integrated to create clinically scalable and durable therapeutic platforms.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148981952","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":"Prevalence and Risk Factors for Ventricular Assist Device-Associated Infection in Children: An Analysis ACTION Study.","authors":"Madeleine Townsend, Neha Bansal, Elizabeth Kalb, Charles Bergstrom, Christopher Knoll, Gabrielle Vaughn, Megan Wilde, Bethany Wisotzkey, Alicia M Kamsheh, Shahnawaz Amdani, Rashmita Naorem, Muhammad Shezad, Jennifer Conway","doi":"10.1111/aor.70241","DOIUrl":"https://doi.org/10.1111/aor.70241","url":null,"abstract":"<p><strong>Background: </strong>Ventricular assist devices (VAD) are increasingly used to bridge children to heart transplantation, but infection is common. The aim of this study was to determine contemporary prevalence and risk factors for VAD-associated infection in children.</p><p><strong>Methods: </strong>A retrospective analysis of the ACTION registry evaluated patients with left or single VAD from 01/04/18-04/30/25. Patients were classified by intracorporeal (IC) vs. paracorporeal (PC) VAD and temporary vs. durable paracorporeal cannulas at infection. Patients with and without VAD-associated infection were compared overall and by VAD type. Risk factors for and one-year survival after infection were evaluated with multivariate analyses.</p><p><strong>Results: </strong>Of 1527 patients, 442 (28.9%) were on IC and 1085 (71.1%) on PC VAD (964 durable, 121 temporary cannulas). There were 152 (10%) patients who developed VAD-associated infection, with no difference in one-year survival. While more patients on PC VAD developed infection overall (PC: n = 94 vs. IC: n = 58), IC VAD patients had a proportionately higher infection rate (13.1% vs. PC durable 9.3% vs. PC temporary 3.3%) (p < 0.05). Median time to infection was later for IC vs. PC VAD (143 vs. 52.5 days, p < 0.0001). Children with infection were more likely to have severe obesity (17.2% vs. 7.8%) and to be on IC VAD (38.2% vs. 27.9%).</p><p><strong>Conclusions: </strong>Nearly 1 in 10 children developed a VAD-associated infection, with no difference in one-year survival. Infection was proportionately higher for IC vs. PC VAD, likely driven by longer time on device. Innovations in driveline management for IC VAD may decrease morbidity for those on long-term support.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975564","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":"Modular Design Approach for Mechanical Circulatory Support Architecture: A Novel Platform for Cross-Technology Applications.","authors":"IFan Yen, Kynan Taylor, Xianshan Qi, Steve Martinuzzo, Chiahao Hsu, Michael Neidlin, Jamshid H Karimov, Po-Lin Hsu","doi":"10.1111/aor.70238","DOIUrl":"https://doi.org/10.1111/aor.70238","url":null,"abstract":"<p><strong>Background: </strong>In a critical care setting, a plethora of life-saving devices, including mechanical circulatory support (MCS) systems, with their powering sources, wiring, and user interfaces, create significant challenges for operational efficiency and patient safety. We report a study of an integrated, user-friendly, modular life support platform (LSP) designed to be suitable for complex clinical and emergency use scenarios.</p><p><strong>Methods: </strong>Surveys were conducted (21 centers of excellence), involving clinical and nursing staff (n = 39), focusing on functional requirements, environmental adaptability, alert systems, and user interfaces. In total, 77 user requirements specifications (URS), 272 product requirements specifications (PRS), and 30 KANO model parameters were analyzed by the cross-functional development team, complemented by industrial design analysis, usability engineering, and iterative validation of device features to produce a coherent modular architecture. We hypothesized that the integrated architecture would support task completion within predefined operational acceptance criteria and minimize potential use errors under simulated-use conditions.</p><p><strong>Results: </strong>The LSP architecture incorporated three configurations: (1) an extracorporeal ventricular assist device (VAD) and adjustable support arm, (2) an extracorporeal membrane oxygenation (ECMO) system with a modular oxygenator and pump, and (3) an investigational percutaneous ventricular assist devices (pVADs) featuring a flushing pump system, a drive motor, and a catheter pump head. Usability testing confirmed its intended adaptability and effectiveness across ICU, ER, and cardiac intensive care units (CICU), operating rooms (OR), and cardiac catheterization laboratories.</p><p><strong>Conclusions: </strong>Demonstrated task completion within predefined operational acceptance criteria, whereas user failure modes and effects analysis (UFMEA) reassessment reduced the numbers of NAC and ALARP risk items.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975596","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":"Monitoring Mitochondrial Function With High-Resolution Respirometry During Ex-Situ Heart Perfusion.","authors":"Lukas Stastny, Julia Hofmann, Andras T Meszaros, Alexandra Ampferer, Gabriel Putzer, Nina Perkins, Natalie Huemer, Florian Sommerauer, Judith Martini, Julian Wagner, Michael Grimm, Stefan Schneeberger, Julia Dumfarth","doi":"10.1111/aor.70213","DOIUrl":"https://doi.org/10.1111/aor.70213","url":null,"abstract":"<p><strong>Background: </strong>Due to the high adenosine-triphosphate (ATP) consumption of the myocardial tissue, cardiac function is dependent on efficient mitochondrial respiration. Ischemia and reperfusion injury (I/R) has a severe impact on the function of the mitochondrial respiratory system. Ex-situ heart perfusion (ESHP) can minimize I/R injury. We investigated mitochondrial respiration using high-resolution respirometry (HRR) in a porcine model during ESHP.</p><p><strong>Methods: </strong>Six German domestic pigs were used as heart and blood donors. Normothermic ESHP was performed over 6 h. Tissue homogenate of porcine myocardium was assessed by HRR at baseline (starting sample), after 60, 180, and 360 min of ESHP.</p><p><strong>Results: </strong>The combined oxidative phosphorylation capacity with NADH, fatty acid and succinate fuel substrates remained stable during ESHP (starting sample: 198 ± 59.7, 60 min: 196.5 ± 66.7, 180 min: 207.5 ± 48.1, 360 min: 200.5 ± 27.9 pmol·s^-1·mg wet mass^-1; p = 0.707). The flux control ratio of the nicotinamide adenine dinucleotide hydrogen (NADH) pathway (starting sample: 0.43 ± 0.07, 60 min: 0.43 ± 0.05, 180 min: 0.47 ± 0.05, 360 min: 0.44 ± 0.07 pmol·s^-1·mg wet mass^-1; p = 0.549) and succinate-pathway (starting sample: 0.49 ± 0.06, 60 min: 0.49 ± 0.05, 180 min: 0.48 ± 0.01, 360 min: 0.5 ± 0.05 pmol·s^-1·mg wet mass^-1; p = 0.814) did not change during perfusion. The mitochondrial outer membrane damage was significantly decreased after 360 min of ESHP (starting sample: 0.39 ± 0.07, 60 min: 0.27 ± 0.06, 180 min: 0.18 ± 0.03, 360 min: 0.17 ± 0.02; p = 0.0124).</p><p><strong>Conclusion: </strong>Our findings demonstrate that normothermic ESHP preserves mitochondrial respiratory function in a porcine model over 6 h. These results provide a mechanistic basis for the potential protective role of normothermic ESHP against ischemia-reperfusion injury. HRR represents a promising investigational tool for in-depth mitochondrial assessment during ESHP.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148928957","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":"Personalized Functional Electrical Stimulation for the Correction of Pathological Gait in Children With Cerebral Palsy Using a Gait Analysis Platform: Toward a Clinically Adapted Solution.","authors":"Gabriel Graffagnino, Benoît Sijobert, Karine Patte, David Gasq, Christine Azevedo-Coste","doi":"10.1111/aor.70239","DOIUrl":"https://doi.org/10.1111/aor.70239","url":null,"abstract":"<p><strong>Background: </strong>Functional electrical stimulation (FES) can improve gait in children with cerebral palsy (CP), but gait impairments vary widely between individuals and likely require stimulation of different muscle groups. Delivering real-time, multichannel, gait-triggered stimulation remains difficult to implement in clinical practice. This study explores the technical feasibility of using gait analysis systems commonly available in pediatric rehabilitation centers to drive multichannel FES. The temporal performance of a real-time, gait-triggered system based on kinematic event detection was evaluated.</p><p><strong>Methods: </strong>Retrospective gait data from 30 children with CP were replayed to emulate real-time acquisition. A custom algorithm detected gait events (initial contact and a knee flexion threshold) and triggered an eight-channel stimulator whose output was recorded via an acquisition card through resistors. Hardware delays were measured across each stage: triggering function, command transmission, and stimulation onset, as well as overall system latency.</p><p><strong>Results: </strong>A total of 1100 gait cycles were analyzed. The mean global latency was 50.33 ms (SD 7.55 ms). Most stimulations occurred within 70 ms (99.45%), and all within 100 ms. The main source of delay was command transmission to the stimulator, while algorithm processing contributed minimally. Performance was consistent across triggering conditions.</p><p><strong>Conclusion: </strong>The proposed approach enables reliable real-time gait-event detection and electrical stimulation triggering with latencies compatible with future clinical application. These results highlight the potential of using gait analysis platforms to flexibly explore and optimize personalized multichannel stimulation strategies, while assessing their immediate orthotic effects prior to translation of the most effective strategies into wearable systems.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918276","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":"Prevention and Management of Driveline Infections in Ventricular Assist Device Patients: The DESTINE 2.0 Staging Proposal and Expert Recommendations.","authors":"Alexander M Bernhardt, Volker Lauenroth, Florian Mueller, Friedrich Kaufmann, Katharina Homann, Martina Socha, Thomas Schlöglhofer","doi":"10.1111/aor.70237","DOIUrl":"https://doi.org/10.1111/aor.70237","url":null,"abstract":"<p><strong>Background: </strong>Driveline infections (DLIs) remain the predominant device-specific complication in patients supported by left ventricular assist devices (LVADs) serving as a major source of morbidity, recurrent hospitalization, and mortality. Despite their clinical impact, the prevention and early management of DLIs lack standardization, particularly within outpatient and home-based care environments.</p><p><strong>Methods and objectives: </strong>The original 2020 DESTINE proposal introduced a standardized dressing protocol and a prevention-oriented staging system for driveline exit-site management. However, subsequent clinical real-world experience revealed limitations, including overly complex early-stage subcategorization and the absence of contemporary guidance on wound care, including fixation strategies, antiseptic agents, and adjunctive therapies.</p><p><strong>Updated recommendations: </strong>DESTINE 2.0 provides expert recommendations to address these gaps. The updated framework features a streamlined five-stage system that consolidates previous subcategories into unambiguous, actionable clinical stages. Enhanced recommendations are provided for driveline immobilization, stage-stratified antiseptic agent selection, and skin barrier preservation. Furthermore, the protocol incorporates adjunctive therapies including cold atmospheric plasma and closed-incision negative pressure wound therapy. Expanded guidance covers modifiable patient-level risk factors, perioperative prophylaxis, showering safety, caregiver education, digital documentation, and stage-directed antibiotic therapy.</p><p><strong>Conclusion: </strong>By providing a practical, integrated framework applicable to multidisciplinary care settings, DESTINE 2.0 aims to optimize infection-free survival, minimize healthcare utilization, and improve quality of life for patients on long-term mechanical circulatory support.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918308","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 Effects of Hollow Fiber Membrane Configuration on Hemodynamic Characteristics, Oxygen Transfer Performance and Thrombosis Risk in Oxygenators: A Numerical Research.","authors":"Anna Teng, Xingji Fu, Xiaofang Yang, Feilong Hei, Anqiang Sun, Zengsheng Chen","doi":"10.1111/aor.70231","DOIUrl":"https://doi.org/10.1111/aor.70231","url":null,"abstract":"<p><strong>Background: </strong>The effects of hollow fiber membrane (HFM) configuration on hemodynamic characteristics, oxygen transfer performance, and thrombosis risk in oxygenators are not clear, and the present study was accomplished to investigate these effects.</p><p><strong>Methods: </strong>Three micro-scale 3D HFM array models were established, with the staggered angle between HFM layers (Φ), the spacing between HFMs (d), and the number of HFM layers (n) as variables. Computational fluid dynamics (CFD) was employed as a predictive tool to quantify wall shear stress (WSS), oxygen partial pressure (PO₂), and saturation (SO₂), activated coagulation factor XII concentration (C[FXIIa]), blood residence time (BRT), and pressure drop (PD) under various flow rates.</p><p><strong>Results: </strong>It was found that larger Φ resulted in higher outlet-averaged PO₂/SO₂, more concentrated BRT and C[FXIIa] at lower values, and higher PD. Similar trends in oxygen transfer were observed when d was decreased or n was increased. However, those conditions were associated with more extensive high-BRT and high-C[FXIIa] regions, which were interpreted as indicating higher thrombosis risk.</p><p><strong>Conclusions: </strong>Based on these predictive results, it is suggested that the inter-layer cross angle should be increased within an acceptable PD range, and that the model porosity should be maintained between 0.4 and 0.6. It is also recommended that the number of layers be reduced for a given volume. Furthermore, it was indicated by the simulations that avoiding extremely large or small flow paths is critical, since larger spacings were predicted to markedly reduce oxygen transfer, while smaller spacings were predicted to increase thrombogenic potential. This study can provide guidance for the design optimization of configurations such as the arrangement of HFMs within the oxygenator.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900029","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":"Predicting Device-Induced Platelet Damage in Assisted Circulation Using a New Biophysical Model and Experimental Validation.","authors":"Anik Tarafder, Dong Han, Bartley P Griffith, Zhongjun J Wu","doi":"10.1111/aor.70233","DOIUrl":"https://doi.org/10.1111/aor.70233","url":null,"abstract":"<p><strong>Background: </strong>Platelet activation and receptor shedding caused by non-physiological shear stress remain a critical challenge in the design and clinical performance of circulatory assist devices. Computational fluid dynamics (CFD)-based approaches have been widely used by coupling flow-derived scalar shear stress with empirical damage models to predict platelet activation. In this study, we evaluate the effectiveness of our recently proposed biophysical damage model for predicting platelet activation and receptor shedding caused by circulatory assist devices.</p><p><strong>Methods: </strong>Four rotary blood pumps have been chosen for this study: One axial pump (HeartMate II) and three centrifugal pumps (HeartMate 3, BrioVAD, and CentriMag). CFD simulations were performed under three clinically relevant circulatory support conditions: HeartMate II, HeartMate 3, BrioVAD at a pressure head of 75 mmHg, along with CentriMag at pressure heads of 75, 150, and 350 mmHg. The resulting platelet damage indices were compared with experimentally measured platelet activation (PAC-1 expression) and receptor shedding (GPIbα and GPVI) data.</p><p><strong>Results: </strong>HeartMate 3, BrioVAD, and CentriMag operating at 75 mmHg caused the lowest levels of platelet activation and receptor shedding, while CentriMag, operating at 350 mmHg, produced the highest, 10 times more activation, and six times more receptor shedding compared to at 75 mmHg. Strong correlations were observed between CFD predicted and in vitro data for all biomarkers ( <math> <mrow><msup><mi>R</mi> <mn>2</mn></msup> <mo>></mo> <mn>0.76</mn></mrow> </math> ), with the highest agreement observed for GPVI shedding ( <math> <mrow><msup><mi>R</mi> <mn>2</mn></msup> <mo>></mo> <mn>0.95</mn></mrow> </math> ).</p><p><strong>Conclusion: </strong>The biophysical model preserved the relative trends observed previously with the power-law formulation, while demonstrating improved agreement with experimental data.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890904","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":"Extended Support With an Impella 5.5: Single-Center Experience and Outcomes.","authors":"Leon Fan, Anagha Gogate, Annie Wang, Maria Morcos, Danica Dong, Chetan Pasrija, AlleaBelle Bradshaw, Ahmet Kilic","doi":"10.1111/aor.70229","DOIUrl":"https://doi.org/10.1111/aor.70229","url":null,"abstract":"<p><strong>Background: </strong>Prolonged use of the Impella 5.5 is becoming increasingly common in patients requiring temporary mechanical circulatory support, yet its association with mortality and neurologic outcomes remains uncertain. We evaluated whether prolonged Impella 5.5 support was independently associated with adverse clinical outcomes at a tertiary center.</p><p><strong>Methods: </strong>We retrospectively studied adults who underwent Impella 5.5 implantation between January 2022 and December 2025. Patients receiving intraoperative support or concomitant extracorporeal membrane oxygenation with Impella were excluded. Prolonged support was defined as duration exceeding the third quartile (> 27 days). The primary outcome was in-hospital mortality. The secondary outcome was unfavorable neurologic outcome at discharge, defined as modified Rankin Scale > 0, with death assigned a score of 6. Multivariable logistic regression adjusted for body mass index (BMI) and Charlson Comorbidity Index (CCI).</p><p><strong>Results: </strong>Among 129 patients (median age 61 years, 74.4% male), median support duration was 15 days. Overall, in-hospital mortality was 21.7%, and unfavorable neurologic outcome occurred in 36.5% of patients. Patients requiring prolonged support had greater comorbidity burden (CCI 3 vs. 2, p = 0.007) and longer intensive care unit (55.59 vs. 25.47 days, p < 0.001) and hospital (78.5 vs. 44.0 days, p < 0.001) stays. However, prolonged support was not independently associated with in-hospital mortality (aOR: 2.16, 95% CI: 0.69-6.54, p = 0.174) or unfavorable neurologic outcome (aOR: 1.58, 95% CI: 0.64-3.90, p = 0.321).</p><p><strong>Conclusions: </strong>Prolonged Impella 5.5 support was associated with greater resource utilization but was not significantly associated with adjusted mortality or adverse neurologic outcomes in this cohort.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863533","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":"SURGELLA: A Scoping Review of Impella-Assisted Hemodynamic Support in High-Risk Non-Cardiac Surgery.","authors":"Hussein Elghazaly, Mohammed Allaf, Areeb Mian, Hanad Ahmed, Alex Gordon-Weeks, Alexander Tindale, Vasileios Panoulas","doi":"10.1111/aor.70219","DOIUrl":"https://doi.org/10.1111/aor.70219","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced heart failure or severe ventricular dysfunction are often considered prohibitively high risk for non-cardiac surgery. Impella may provide temporary perioperative hemodynamic support by augmenting cardiac output and unloading the left ventricle, but evidence for this strategy remains limited and largely case based.</p><p><strong>Methods: </strong>We conducted a scoping review of Impella use for adult high-risk non-cardiac surgery. MEDLINE and Embase were searched from inception to April 2026, with supplementary hand-searching and citation tracking. Eligible reports were synthesized descriptively, with particular attention to implantation timing, operative context, device strategy, outcomes, and complications.</p><p><strong>Results: </strong>Twenty-three publications comprising 36 unique patients were identified. Evidence consisted mainly of case reports and small series. Impella was used across bariatric, abdominal, oncological, endocrine, transplant-related, vascular, orthopedic, and neurosurgical procedures. Clinical strategies included planned pre-emptive support, surgery during established Impella or ECMELLA support, rescue implantation after perioperative deterioration, and combined support strategies. Operative completion was usually reported and 34 of 36 unique published patients survived to hospital discharge; however, this reflects selected published experience rather than a reliable estimate of effectiveness or safety.</p><p><strong>Conclusions: </strong>Impella-supported non-cardiac surgery appears technically feasible in highly selected patients treated in specialist centers. Current evidence supports feasibility, not comparative benefit or generalizable safety. Prospective multicenter data with standardized reporting are required before wider adoption can be justified.</p>","PeriodicalId":8450,"journal":{"name":"Artificial organs","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863559","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}