ASAIO Journal最新文献

{"title":"A Biophysics-Based Mathematical Model of Shear-Induced Platelet Activation and Receptor Shedding: Re-Examining Previous Experimental Data.","authors":"Dong Han, Anik Tarafder, Bartley P Griffith, Zhongjun J Wu","doi":"10.1097/MAT.0000000000002399","DOIUrl":"10.1097/MAT.0000000000002399","url":null,"abstract":"<p><p>The power-law model, originally developed for shear-induced hemolysis, has been used to predict shear-induced platelet activation and receptor shedding. However, its empirical nature lacks mechanistic explanations and violates physical reality by not imposing an upper limit, often leading to inaccuracies. Recent studies suggest that the mechanical pulling of platelet GPIb-IX complex triggers the unfolding of its mechanosensitive domain, a crucial process to platelet activation, which can be explained by Bell's model of bond unbinding under force. Motivated by these findings, we propose a novel mathematical model for shear-induced platelet activation (P-selectin) and shear-induced platelet receptor (glycoprotein Ibα [GPIbα], GPVI, and GPIIb/IIIa) shedding based on the principle of bond unbinding. The model was examined using experimental data from previous studies in which blood samples were exposed to different combinations of constant shear stress and exposure time. The new model demonstrated an excellent fit with experimental data with an overall coefficient of determination R2 >0.8, mapping the trends in platelet activation and receptor shedding (except for GPIIb/IIIa) across a range of shear conditions. This new model not only addresses the intrinsic upper bound error in the power-law model but also provides a theoretical foundation into blood damage under shear stress.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"621-627"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in Neutrophil-to-Lymphocyte Ratio During Venoarterial Extracorporeal Membrane Oxygenation: Response.","authors":"Jose I Nunez, Omar Saeed","doi":"10.1097/MAT.0000000000002408","DOIUrl":"10.1097/MAT.0000000000002408","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e125"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522347","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":"HeartMate 3 Ventricular Assist Device in a Single-Ventricle and Single-Lung Patient Palliated With a Bidirectional Glenn.","authors":"Luiz Fernando Caneo, Carolina Vieira de Campos, Marcelo Biscegli Jatene, João Gabriel Guedes da Cunha Mello, Isabela Guersoni Menna Barreto, Fabio Biscegli Jatene","doi":"10.1097/MAT.0000000000002333","DOIUrl":"10.1097/MAT.0000000000002333","url":null,"abstract":"<p><p>We describe a 15 year old patient with failing second-stage single-ventricle palliation and left pulmonary artery thrombosis successfully supported with HeartMate 3 ventricular assist device and a Fontan completion as destination therapy.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"e120-e123"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142457083","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":"Survival and Readmission Burden in Advanced Heart Failure Patients Managed With Ventricular Assist Device Versus Continued Medical Therapy.","authors":"Jeffrey D Alexis, Katherine Wood, Igor Gosev, Anas Jawaid, Leway Chen, Anuradha Godishala, Mark Tallman, Sabu Thomas, John Martens, Bronislava Polonsky, Anita Y Chen, Scott McNitt, Saadia Sherazi, Ilan Goldenberg","doi":"10.1097/MAT.0000000000002382","DOIUrl":"10.1097/MAT.0000000000002382","url":null,"abstract":"<p><p>As questions remain about the risk-benefit of left ventricular assist device (LVAD) therapy, we evaluated the association between LVAD versus medical therapy for the competing risk of all-cause mortality and all-cause readmission. Among consecutive patients evaluated for advanced heart failure (HF) therapy, 260 were referred for LVAD implantation and 292 continued medical therapy in this retrospective, observational database study. At 2 years, all-cause mortality was significantly higher among medically managed patients versus LVAD recipients (37% vs. 25%, p = 0.014). Separation in event rates appeared within 3 months and was sustained throughout follow-up. The cumulative incidence rate of all-cause readmissions at 2 years was higher among LVAD recipients (78% vs. 40%, p < 0.001). In multivariate analysis, compared with medical therapy, LVAD therapy was associated with a significant 35% lower risk of death ( p = 0.005), driven by a 57% reduction in the risk of death within the first 3 months ( p < 0.001), and a 2.8-fold increased risk of readmission. Among medically managed patients, lower baseline hemoglobin and blood pressure, older age, and increased creatinine were predictors of death. In conclusion, among patients with advanced HF, LVAD therapy was associated with pronounced survival benefit, but a higher 2-year readmission rate compared with medical management.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"628-636"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540017","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 Use Experience of the Crescent Right Atrial Cannula for Neonatal Veno-Venous Extracorporeal Membrane Oxygenation.","authors":"Michael Sobolic, Yujin Park, Sharada H Gowda, Nicholas R Carr, Rachel Chapman, Annie Chi, Goeto Dantes, Vedanta Dariya, Daniel R Dirnberger, Caraciolo J Fernandes, Shannon Hamrick, Swosti Joshi, Sarah Keene, Allison Linden, Abhishek Makkar, Ogechukwu Menkiti, Franscesca Miquel-Verges, Vilmaris Quinones-Cardona, Rakesh Rao, Ricardo J Rodriguez, Ruth Seabrook, Patrick Sloan, Denise Suttner, Mark F Weems, Leslie Lusk, Natalie Rintoul, Robert DiGeronimo, Brian W Gray","doi":"10.1097/MAT.0000000000002371","DOIUrl":"10.1097/MAT.0000000000002371","url":null,"abstract":"<p><p>Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is associated with fewer neurological complications and decreased mortality compared to veno-arterial (VA) ECMO in neonatal respiratory failure. The Crescent right atrial (RA) cannula is the only dual-lumen cannula for neonatal VV ECMO designed to have the tip in the right atrium. The purpose of this study is to describe the experience with early use of the Crescent RA cannula. We performed a retrospective cohort study of 58 neonates and infants cannulated from September 2021 through August 2023 at 15 institutions represented within the Children's Hospital Neonatal Consortium (CHNC) ECMO Focus Group. Members provided information on patient characteristics, ECMO runs, complications, and outcomes. Data were analyzed with descriptive statistics. Imaging was used during cannulation in 79.3% of cases. Survival to discharge was 84.5%. There was one major cannula-related complication resulting in death. The most common complication was cannula malposition in 46.6% of patients, requiring surgical repositioning in 29.3% of the total cohort. Early use experience with the Crescent RA cannula suggests that it is effective and safe in most patients, but the cannula may require repositioning to achieve optimal ECMO support or if malpositioned. Based on these observations, we developed recommendations for cannulation and cannula surveillance.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"660-666"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955955","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":"Subnormothermic Machine Perfusion of Neonatal and Small-Sized Pediatric Donor Hearts.","authors":"Mitchell J Wagner, Guilherme Mainardi Aguiar da Silva, Sanaz Hatami, Mubashir Khan, Lily Lin, Xiuhua Wang, Tara Pidborochynski, Benjamin Adam, Jayan Nagendran, Jennifer Conway, Darren H Freed","doi":"10.1097/MAT.0000000000002366","DOIUrl":"10.1097/MAT.0000000000002366","url":null,"abstract":"<p><p>Donor heart machine perfusion enables avoidance of prolonged cold ischemia, however the optimal temperature is yet to be elucidated. Given that maintenance of temperature beyond ambient levels demands significant energy, we sought to determine the suitability of room-temperature perfusion preservation of neonatal/pediatric-sized (5-20 kg) piglet donor hearts. A custom device was fabricated suitable for this purpose, with continuous readout of perfusion pressure, flow rate, temperature, and oxygen saturation. Oxygen delivery was automated to keep saturation above 90%. The perfusate consisted of a 1:1 mix of donor whole blood and modified Krebs-Henseleit solution with albumin. Donor hearts were procured from 5 kg (n = 5), 10 kg (n = 3), and 20 kg (n = 5) piglets, and perfused for 10 hours. Subsequently, 20 kg piglet hearts were transplanted. Hemodynamic stability and echocardiographic measurement of donor heart function were evaluated posttransplant. Perfusate parameters were stable through the perfusion interval. Temperature was consistently 23.8 ± 1.6°C. pH (7.35 ± 0.09) and pO 2 (102 ± 29 mm Hg) were steady throughout. Glucose (5.9 ± 1.8 mmol/L) and lactate (2.4 ± 1.5 mmol/L) were metabolized by the heart over the course of perfusion. Transplanted hearts displayed durable hemodynamics and good biventricular function. We conclude that neonatal and pediatric hearts can be safely perfused for extended periods at subnormothermic conditions using blood-based perfusate.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"652-659"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862943","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":"Why Outcome Definition Precedes Risk of Bias Assessment in Extracorporeal Membrane Oxygenation Bleeding Research.","authors":"Oliver Karam, Christie Atchison, Madhuradhar Chegondi","doi":"10.1097/MAT.0000000000002527","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002527","url":null,"abstract":"","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759041","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 Extracorporeal Membrane Oxygenation Initiation May Improve Outcomes in Select Patients With Primary Pulmonary Hypertension: An Extracorporeal Life Support Organization Registry Analysis.","authors":"Benjamin Smood, Charles R Vasquez, Salim E Olia, Jason J Han, Amit Iyengar, William L Patrick, Mark R Helmers, John J Kelly, Thomas Richards, Asad Usman, Edward Cantu, Koji Takeda, Nathaniel Langer, Marisa Cevasco","doi":"10.1097/MAT.0000000000002390","DOIUrl":"10.1097/MAT.0000000000002390","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) utilization for primary pulmonary hypertension (PPHTN) remains controversial. This multicenter, retrospective analysis of the Extracorporeal Life Support Organization Registry evaluated 221 PPHTN patients placed on ECMO in 2000-2019. Survival by ECMO indications and cannulation strategies were compared with Kaplan-Meier analyses. ECMO mortality risk factors were analyzed using Cox proportional hazards regressions. The overall rate of survival to ECMO decannulation was 140/221 (63.3%), of which 112/140 (80.0%) survived to hospital discharge. Survival to decannulation increased between 2000-2009 (14/30, 46.7%) and 2010-2019 (126/191, 66.0%, p = 0.041) alongside survival to hospital discharge (9/30, 30.0% vs. 103/191, 53.9%, p = 0.015). Survival to decannulation was similar when patients were supported with either venovenous-ECMO (VV-ECMO; 39/54, 72.2%) or venoarterial-ECMO (VA-ECMO) for respiratory failure (43/71, 60.6%, p = 0.174), although VV-ECMO was associated with fewer complications (25/54, 46% vs. 25/71, 35%, respectively, p = 0.039) and increased survival to hospital discharge (34/54, 63.0% vs. 33/71, 46.5%, p = 0.067). The strongest independent predictor of ECMO morality was isolated vasopressor use before cannulation (hazard ratio [HR]: 3.37 [95% confidence interval {CI 95% }: 1.16-9.81], p = 0.026). Extracorporeal membrane oxygenation mortality risk was lower among patients bridged-to-transplantation (HR: 0.37 [CI 95% : 0.14-0.97], p = 0.043), and was inversely correlated with pre-ECMO pH (HR: 0.03 [CI 95% : 0.00-0.49], p = 0.013). Extracorporeal membrane oxygenation use for PPHTN has grown alongside improved outcomes. Early ECMO initiation may improve outcomes in select individuals with PPHTN.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"611-620"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sepsis-Extracorporeal Membrane Oxygenation Score in Patients Receiving Extracorporeal Membrane Oxygenation Support for Sepsis.","authors":"Hongfu Fu, Liangshan Wang, Yan Wang, Yaxin Xie, Haixiu Xie, Xiaotong Hou, Hong Wang","doi":"10.1097/MAT.0000000000002409","DOIUrl":"10.1097/MAT.0000000000002409","url":null,"abstract":"<p><p>Predictive scoring systems for adult patients receiving extracorporeal membrane oxygenation (ECMO) support for sepsis have not been yet reported. Based on the Chinese Society of ExtraCorporeal Life Support (CSECLS) Registry database, we conducted a retrospective observational study on adult patients supported with ECMO for sepsis (n = 465). On the basis of multivariable logistic regression analyses, four parameters at 24 h post-ECMO initiation ( T24 ) were identified as prognostic factors associated with in-hospital mortality: age, vasoactive inotropic score (VIS), partial pressure of oxygen in arterial blood (PaO 2 ), and lactate clearance. The sepsis-ECMO score was calculated based on these prognostic factors, which were converted into categorical variables. The area under the receiver operating characteristic curve for the sepsis-ECMO score was 0.704 (95% confidence interval [CI]: 0.658-0.751). Four risk classes, namely class Ⅰ (score 0), class Ⅱ (score 5), class Ⅲ (score 6-10), and class Ⅳ (score ≥ 11), were identified according to sepsis-ECMO score quartiles. Patients in the lower sepsis-ECMO score classes had significantly better survival than those in the higher classes (log-rank test, p < 0.001). The sepsis-ECMO score may help in the risk stratification of patients, facilitate the communication of objective prognostic information, and provide a clearer direction for shared decision-making.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":"644-651"},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impella 5.5 Versus Intra-Aortic Balloon Pump for Bridging Heart Transplant Patients: A Contemporary Analysis of the United Network for Organ Sharing Database.","authors":"Athanasios Tsiouris, Gabriel A Hernandez, Seth T Lirette, Ashok Kumar Coimbatore Jeyakumar, Lampros Papadimitriou","doi":"10.1097/MAT.0000000000002520","DOIUrl":"https://doi.org/10.1097/MAT.0000000000002520","url":null,"abstract":"<p><p>Anecdotally, over the past 2 years, many transplant centers in the United States have shifted toward using Impella 5.5 instead of intra-aortic balloon pumps (IABP) for less sick patients. The aim of our study is to determine if Impella 5.5 devices are now used more liberally for status 2 heart transplant candidates and whether this confers any benefit to post heart transplant outcomes. We evaluated the United Network for Organ Sharing Database (UNOS) database and analyzed status 2 patients who underwent heart transplantation after being bridged with an Impella 5.5 or IABP from October 2019 to March 2024. The rate of Impella implants for supporting status 2 candidates significantly increased from 9% to 35% (p < 0.001). More patients in the Impella cohort were on inotropic support at the time of transplant (63% vs. 58%; p = 0.013) and were more likely to have undergone previous cardiac surgery (25% vs. 20%; p = 0.04). The Impella 5.5 patients had an overall shorter length of hospital stay compared with the IABP patients (20.4 vs. 22.5 days; p = 0.05), but there was a significantly higher rate of stroke in the Impella 5.5 group (5% vs. 3%, p = 0.016). A more detailed cost-effective analysis is required to determine if the increased utilization of this device is justified based on its increased cost.</p>","PeriodicalId":8844,"journal":{"name":"ASAIO Journal","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759039","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}