Effect of proactive combination therapy with peritoneal dialysis and hemodialysis on technique survival and mortality
ConclusionUse of combination therapy in the induction phase might prolong the duration of combination therapy, but is not necessarily effective for prolonging peritoneal dialysis technique survival. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - March 22, 2024 Category: Transplant Surgery Source Type: research

Utilizing a long sheath to minimize atheroma manipulation (minimal manipulation approach) during Zone 1 and 2 thoracic endovascular aortic repair with a shaggy aorta
AbstractWe have adopted a simple and reproducible approach, “minimal manipulation approach,” since January 2021 in five patients to minimize the risk of thromboembolic events during Zone 1 and 2 thoracic endovascular aortic repair (TEVARs) with shaggy aorta. The approach consists of two parts: ① Use of a 65-cm-long sheath (dry seal) to deliver the endo grafts without touching the protruding atheroma. Covering the atheroma with the first endograft delivered at Zone 3 to the mid-descending aorta (paving the aorta), and second endograft insertion and deployment through the paved aorta with first endograft. ② Protectio...
Source: Journal of Artificial Organs - March 21, 2024 Category: Transplant Surgery Source Type: research

Predictive role of regional thigh tissue oxygen saturation monitoring during cardiopulmonary bypass in lung injury after cardiac surgery
This study investigated the association of regional oxygen saturation (rSO2) during CPB with postoperative outcomes, including respiratory function. Patients who underwent cardiac surgery with CPB from 2015 to 2019 were included. Near-infrared spectroscopy was used to monitor rSO2 at the forehead, abdomen, and thighs throughout the surgery. Postoperative markers associated with CPB were assessed for correlations with PaO2/FiO2 (P/F) ratios at intensive care unit (ICU) admission. Postoperative lung injury (LI) was defined as moderate or severe ARDS based on the Berlin criteria, and its incidence was 29.9% (20/67). On multip...
Source: Journal of Artificial Organs - March 18, 2024 Category: Transplant Surgery Source Type: research

Left ventricular assist devices: yesterday, today, and tomorrow
AbstractThe shortcomings of expense, power requirements, infection, durability, size, and blood trauma of current durable LVADs have been recognized for many years. The LVADs of tomorrow aspire to be fully implantable, durable, mitigate infectious risk, mimic the pulsatile nature of the native cardiac cycle, as well as minimize bleeding and thrombosis. Power draw, battery cycle lifespan and trans-cutaneous energy transmission remain barriers to completely implantable systems. Potential solutions include decreases in pump electrical draw, improving battery lifecycle technology and better trans-cutaneous energy transmission,...
Source: Journal of Artificial Organs - March 7, 2024 Category: Transplant Surgery Source Type: research

Successful management of HeartMate 3 in a patient with arrhythmogenic right ventricular cardiomyopathy
AbstractThe management of right heart failure during durable left ventricular assist device (LVAD) support remains an unsolved issue so far. We had a 44-year-old male patient who was diagnosed with arrhythmogenic right ventricular cardiomyopathy and received HeartMate 3 LVAD (Abbott, USA) implantation as a bridge-to-transplant indication. The pump speed was adjusted as low as 4500  rpm to avoid the left ventricular narrowing and interventricular septal leftward shift. Riociguat was administered to decrease the afterload of the right ventricle and increase the preload of the left ventricle, in addition to the combination o...
Source: Journal of Artificial Organs - February 24, 2024 Category: Transplant Surgery Source Type: research

Prevalence of bleeding events in real-world Japanese registry for Percutaneous Ventricular Assist Device
ConclusionThis study represents the first 3-year survival and the safety profile focused on bleeding adverse events from the J-PVAD registry. The results show that the real-world frequency of bleeding adverse events for patients who received Impella was an expected range from previous reports, and future real-world studies should aim to expand this data set to improve outcomes and adverse events. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - February 24, 2024 Category: Transplant Surgery Source Type: research

Contributing factors to heparin resistance during cardiopulmonary bypass
AbstractSince the risk factors for heparin resistance (HR) before cardiopulmonary bypass (CPB) have not been fully clarified, this study investigated the contributing factors for HR after the initial unfractionated heparin (UFH) dose of 500  IU/kg. We retrospectively analyzed the data of 371 patients who underwent CPB surgery, with the initial UFH dose of 500 IU/kg, between May 2017 and December 2021. We defined HR as the failure to achieve activated clotting time (ACT) of >  480 s after the initial UFH dose of 500 IU/kg. HR was observed in 36 patients (9.7%) (HR group), while HR was not observed in 335 patients...
Source: Journal of Artificial Organs - February 17, 2024 Category: Transplant Surgery Source Type: research

3D porous structure imaging of membranes for medical devices using scanning probe microscopy and electron microscopy: from membrane science points of view
AbstractThe evolution of hemodialysis membranes (dialyzer, artificial kidney) was remarkable, since Dow Chemical began manufacturing hollow fiber hemodialyzers in 1968, especially because it involved industrial chemistry, including polymer synthesis and membrane manufacturing process. The development of hemodialysis membranes has brought about the field of medical devices as a major industry. In addition to conventional electron microscopy, scanning probe microscopy (SPM), represented by atomic force microscopy (AFM), has been used in membrane science research on porous membranes for hemodialysis, and membrane science cont...
Source: Journal of Artificial Organs - February 5, 2024 Category: Transplant Surgery Source Type: research

On the total albumin losses during haemocatharsis
AbstractExcessive albumin losses during HC (haemocatharsis) are considered a potential cause of hypoalbuminemia —a key risk factor for mortality. This review on total albumin losses considers albumin “leaking” into the dialysate and losses due to protein/membrane interactions (i.e. adsorption, “secondary membrane formation” and denaturation). The former are fairly easy to determine, usually varying at the level of ~ 2 g to ~ 7 g albumin loss per session. Such values, commonly accepted as representative of the total albumin losses, are often quoted as limits/standards of permissible albumin loss per session....
Source: Journal of Artificial Organs - January 18, 2024 Category: Transplant Surgery Source Type: research

Rigid fixation of pelvic tracker essential for accurate cup placement in CT-based navigation total hip arthroplasty
AbstractResearch is lacking on the effect of intraoperative pelvic tracker displacement relative to the pelvis on cup orientation accuracy in computed tomography (CT)-based navigation (CTN) or multivariable analysis to detect factors associated with CTN accuracy. Here, we asked: (1) how pelvic tracker displacement influences the CTN accuracy of cup orientation in total hip arthroplasty (THA)? and (2) what factors are associated with CTN accuracy on multivariable analysis? Regarding cup orientation in 446 THA procedures using CTN, we evaluated clinical error defined as the difference between postoperative measurement and pr...
Source: Journal of Artificial Organs - January 10, 2024 Category: Transplant Surgery Source Type: research

Characteristics of macrophage aggregates prepared by rotation culture and their response to polymeric materials
In this study, the interaction of THP-1 cell-differentiated macrophages with biomaterials was analyzed based on a new method of seeding THP-1 cells. THP-1 cells were cultured in static and rotation culture without and with PMA. In undifferentiated THP-1 cells, there was no change in cellular function between static and rotation cultures. In rotation culture with PMA, THP-1 cells differentiated and formed macrophage aggregates. IL-1 β and MRC1 expression in macrophage aggregates was examined after differentiation and M1/M2 polarization. Macrophage aggregates in rotation culture tended to be polarized toward M2 macrophages ...
Source: Journal of Artificial Organs - January 9, 2024 Category: Transplant Surgery Source Type: research