ASAIO JournalPub Date : 2025-06-18DOI: 10.1097/MAT.0000000000002488
Tarun Dalia, Hassan Farhoud, Andrija Vidic
{"title":"Reply Letter to \"Reassessing the Chill: A Critical Perspective on SherpaPak Versus Ice Storage in Heart Transplantation\".","authors":"Tarun Dalia, Hassan Farhoud, Andrija Vidic","doi":"10.1097/MAT.0000000000002488","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002488","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324400","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}
ASAIO JournalPub Date : 2025-06-17DOI: 10.1097/MAT.0000000000002479
Zachary S Jarrett, Hui Xia, Erika R O'Neil, Terence P Lonergan, Michael Gonzales, Michal Sobieszczyk, Thomas F Gibbons, Joseph E Marcus
{"title":"Characterizing Microbiome Changes in Veno-Venous Extracorporeal Membrane Oxygenation: A Case Report of Multidrug-Resistant Bacteremia.","authors":"Zachary S Jarrett, Hui Xia, Erika R O'Neil, Terence P Lonergan, Michael Gonzales, Michal Sobieszczyk, Thomas F Gibbons, Joseph E Marcus","doi":"10.1097/MAT.0000000000002479","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002479","url":null,"abstract":"<p><p>Microbiome analysis using metagenomics next-generation sequencing (mNGS) is rarely performed in patients receiving extracorporeal membrane oxygenation (ECMO). Patient body sites were swabbed within 72 hours of ECMO cannulation and weekly during ECMO course. Specimens underwent 16S sequencing to identify the microbiome along with mNGS to determine antimicrobial resistance genes. Fifty-two year old male who suffered polytraumatic injuries and developed acute respiratory syndrome was placed on veno-venous (VV) ECMO to treat severe respiratory failure. On ECMO day 1, the patient was undergoing treatment for urinary tract infection due to susceptible Pseudomonas aeruginosa (PsA). On ECMO day 22, the patient developed fulminant septic shock and tracheal aspirate and blood cultures both grew MDR PsA and Enterobacter cloacae complex (ECC) and ultimately died on day 23. There were significant microbiome and antimicrobial resistance changes that preceded sepsis on day 22, as evidenced by the increase in oral PsA colonization and expansion of resistance genes, such as KPC and OXA-50, which suggest several possible reservoirs for infection outside of the circuit. Further application of these methods is needed to understand microbiome changes in ECMO and ultimately guide infection prevention efforts.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144315851","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}
ASAIO JournalPub Date : 2025-06-16DOI: 10.1097/MAT.0000000000002484
Peter Marogil, Yu Xia, Joshua Hermsen, Maryl Johnson, Veli K Topkara
{"title":"Post-Transplant Stroke in Patients Bridged to Transplantation With Impella 5.5 in the Era of Prolonged Duration of Support.","authors":"Peter Marogil, Yu Xia, Joshua Hermsen, Maryl Johnson, Veli K Topkara","doi":"10.1097/MAT.0000000000002484","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002484","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301045","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}
ASAIO JournalPub Date : 2025-06-12DOI: 10.1097/MAT.0000000000002478
Hamzah Almadani, Youssef Aref, Zachary Brennan, Andrew Cantor, Tyler Gunn, Philip S Brazio
{"title":"Fluorescent Imaging-Guided Ligation of Lymphatic Leaks Following Decannulation From Extracorporeal Membrane Oxygenation.","authors":"Hamzah Almadani, Youssef Aref, Zachary Brennan, Andrew Cantor, Tyler Gunn, Philip S Brazio","doi":"10.1097/MAT.0000000000002478","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002478","url":null,"abstract":"<p><p>Lymphocele is a known complication of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). We present a novel application of fluorescent lymphatic imaging for the highly selective treatment of lymphatic leaks after VA-ECMO and describe patient outcomes at our institution. A retrospective review of patients who underwent lymphatic ligation following VA-ECMO from 2022 to 2024 was performed. Fluorescent imaging and intradermal indocyanine green injection were used to identify and ligate lymphatic leaks within the debrided wound bed. Ten patients with a mean age of 48.3 years were included. The mean number of lymphatics ligated was 5. Mean days from decannulation to ligation and from ligation to drain removal were 18.4 and 22.2, respectively. There was a significant decrease in drain output immediately following ligation (197.4 ml/day vs. 64.2 ml/day; p = 0.016). A shorter time from decannulation to ligation was significantly correlated with a decrease in drain output. A higher drain fluid lymphocyte percentage was significantly correlated with a shorter time to drain removal. Fluorescent imaging-guided lymphatic ligation is an effective method for treating lymphatic leak after decannulation from VA-ECMO. Drain fluid analysis and early consultation with plastic surgery should be encouraged in the event of high-output lymphocele.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274076","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":"Use of Therapeutic Drug Monitoring to Personalize Antifungals for Blastomycosis in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Case Series.","authors":"Rana Khafagy, Erin Chung, Anne-Marie Guerguerian, Cory Anderson, Elaine Gilfoyle, Mark Todd, Sandra Pong, Mariella Vargas-Gutierrez, Gail Annich","doi":"10.1097/MAT.0000000000002480","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002480","url":null,"abstract":"<p><p>Amphotericin B and posaconazole are used in the treatment of pulmonary blastomycosis. Previous reports found inadequate treatment to both antifungals due to potential sequestration in extracorporeal membrane oxygenation (ECMO). There is a lack of evidence supporting routine use of therapeutic drug monitoring (TDM) with these agents. We report amphotericin B and posaconazole TDM in two separate cases of patients with pulmonary blastomycosis and on ECMO. Plasma concentrations were collected pre- and post-ECMO membranes and used to calculate pharmacokinetic and pharmacodynamic parameters. Drug sequestration within ECMO was not evident in our cases. As such, we speculate the drugs may have saturated the circuits over time. TDM of amphotericin B and posaconazole may be beneficial in pediatric patients on ECMO, especially near initiation of therapy or after a circuit change. Further studies are warranted to evaluate the relationship between plasma concentrations of these antifungals and efficacy and safety outcomes.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274078","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}
ASAIO JournalPub Date : 2025-06-12DOI: 10.1097/MAT.0000000000002481
Ibrahim Nagmeldin Hassan
{"title":"Reassessing the Chill: A Critical Perspective on SherpaPak Versus Ice Storage in Heart Transplantation.","authors":"Ibrahim Nagmeldin Hassan","doi":"10.1097/MAT.0000000000002481","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002481","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274077","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}
ASAIO JournalPub Date : 2025-06-02DOI: 10.1097/MAT.0000000000002475
Albert Leng, Preetham Bachina, Olivia Liu, Benjamin Shou, Charles Racz, David A Giliver, Ilya Shpitser, Glenn J R Whitman, Sung-Min Cho
{"title":"Enhancing Survival Prediction After Venoarterial Extracorporeal Membrane Oxygenation Using Machine Learning.","authors":"Albert Leng, Preetham Bachina, Olivia Liu, Benjamin Shou, Charles Racz, David A Giliver, Ilya Shpitser, Glenn J R Whitman, Sung-Min Cho","doi":"10.1097/MAT.0000000000002475","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002475","url":null,"abstract":"<p><p>In-hospital mortality after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remains high. This study compared the performance of the Survival after Venoarterial ECMO (SAVE) score with machine learning (ML) models incorporating rich electronic medical record data to evaluate survival for patients on VA-ECMO support. We retrospectively reviewed adults undergoing VA-ECMO (2016-2022) at a single tertiary care center. The CatBoost algorithm was trained using leave-one-out cross-validation (LOOCV) on 74 extracted vital signs, laboratory values, and ventilator settings. Shapley Additive Explanations (SHAP) was used to identify key predictive features for logistic regression. Overall, 194 VA-ECMO patients (median age = 58 years, 36.6% female) were included, with 133 (69%) experiencing mortality. The SAVE score was compared to two predictive models: a pre-ECMO model (≤ 24 hours before cannulation) and an on-ECMO model (including up to the first 48 hours of ECMO). The LOOCV area under the receiver-operator characteristics curves (AUC) for the SAVE score, pre-ECMO, and on-ECMO models was 0.73, 0.77, and 0.83, respectively. Logistic regressions using ML-identified variables showed stepwise AUC improvements: 0.82 (pre-ECMO), 0.86 (on-ECMO), and 0.89 (combined). A novel, interpretable ML model predicted survival for VA-ECMO patients with accuracy comparable to the SAVE score. Incorporating on-ECMO variables significantly increased predictive performance and revealed novel variables associated with survival.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198221","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}
ASAIO JournalPub Date : 2025-06-01Epub Date: 2024-12-16DOI: 10.1097/MAT.0000000000002361
Mauro Renghini, Debora Maddinelli, Anna Papeo, Carmine Puglia, Andrea Montisci, Sergio Cattaneo, Stefano Benussi
{"title":"Clinical Practice With Preprimed Extracorporeal Membrane Oxygenation: Safety, Sterility, and Functionality.","authors":"Mauro Renghini, Debora Maddinelli, Anna Papeo, Carmine Puglia, Andrea Montisci, Sergio Cattaneo, Stefano Benussi","doi":"10.1097/MAT.0000000000002361","DOIUrl":"10.1097/MAT.0000000000002361","url":null,"abstract":"<p><p>This 5 year retrospective study presents the clinical experience with preprimed extracorporeal membrane oxygenation (ECMO) circuits used in a Single Hub Center Hospital, focusing on sterility, functionality, and safety. The ECMO program has been active since 2019, with a total of 223 circuits managed. Our preassembled and preprimed ECMO circuits were stored in a sterile environment and continuously circulated until implantation. Sterility and functionality testing was performed at the end of circuit preparation, every 7 days, and before implantation. Our results show that only 2 (0.3%) of the 570 samples tested positive for bacteria, and all implanted devices demonstrated satisfactory gas transfer performance. None of the ECMO devices demonstrated any loss of early functionality after implantation. The longest storage period of a preprimed circuit was 73 days, with no positive culture results. Our study highlights the importance of preassembled and preprimed ECMO circuits in improving clinical practice in emergency situations, highlighting their safety and potential to improve clinical practice. Furthermore, our findings suggest that standardizing guidelines for prepriming and storage of ECMO circuits can help minimize the risk of contamination.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"454-460"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827233","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}
ASAIO JournalPub Date : 2025-06-01Epub Date: 2025-02-20DOI: 10.1097/MAT.0000000000002394
Jorik H Amesz, Niki L Lupgens, Dirk J Duncker, Lisa E Sluijter-Rozendaal, Dwight Dumay, Olivier C Manintveld, Yannick J H J Taverne
{"title":"A Smart Computational Tool for Personalized Coronary Blood Flow Settings During Normothermic Ex Situ Heart Perfusion.","authors":"Jorik H Amesz, Niki L Lupgens, Dirk J Duncker, Lisa E Sluijter-Rozendaal, Dwight Dumay, Olivier C Manintveld, Yannick J H J Taverne","doi":"10.1097/MAT.0000000000002394","DOIUrl":"10.1097/MAT.0000000000002394","url":null,"abstract":"<p><p>Myocardial edema significantly develops during current subnormothermic ex situ heart perfusion (ESHP) procedures, resulting in myocardial function decline during prolonged perfusion. A relatively high coronary blood flow (CBF) during ESHP is thought to be responsible for this high degree of myocardial edema formation. In this study, we present a novel tool to calculate CBF based on individual donor (sex and body weight) and perfusate (hemoglobin concentration, oxygen saturation, partial pressure of oxygen [PO 2 ]) characteristics. The tool continuously evaluates the balance between myocardial oxygen consumption (MVO 2 ) and delivery to facilitate adequate and preventing excess perfusion. Taking this personalized approach, the CBF can potentially be lowered while still providing sufficient oxygen to the donor heart. Furthermore, the tool automatically calculates MVO 2 , ΔPO 2 , and coronary vascular resistance during ESHP, which aids in the qualitative assessment of the heart before transplantation.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e90-e93"},"PeriodicalIF":3.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12122086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466847","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}