International Journal of Artificial Organs最新文献

Progress of breakthrough Roll Porous Scaffold (RPS) 3D Bioprinting technology with great potential for personalized medicine, targeted therapy and overcoming the shortage of organs for implantation achieves first physical confirmation. The efficiency of RPS for the formation of solid organoid can exceed liters per hour with ~10-35 µm cells in 5, 18, and 84 pL drops due to significantly increased print exposure for cell filtration and based on the lines of many usual Kyocera inkjet printheads "KJ4B-1200," "KJ4C-0360," and "KJ4A-0300, KJ4B-0300" with resolution of 1200, 360, and 300 DPI accordingly. Films samples were made and a method was developed to control the formation of an object inside a roll not by one, but by two parameters. After laser perforation of these ribbons with 1200 DPI precision, holes size of ~60-120 µm and boundaries of ~20-45 µm respectively, the MTT (methylthiazolyl tetrazolium) assay with 8 replicates for each experimental group according to GOST ISO 10993-5:2023 showed good cell viability of >78%-97%. An additional parameter for formatting the reinforcing tape from a durable incompressible material, which determines the thickness of the wind layer, allows taking into account its uneven height when forming a 3D model of the organoid.

Objectives: The persistent challenges posed by ovarian cancer, marked by its high mortality rates and resistance to conventional therapies, drive a continuous search for innovative and effective treatment strategies. In the current study, laurus nobilis extract was loaded into chitosan nanoparticles to investigate its potential anti-cancer effects against SKOV3 ovarian cancer cells.

Methods: The developed nanocarriers were loaded into a collagen hydrogel to better mimic the tumor microenvironment. In vitro studies including scanning electron microscopy, cell viability assay, cell migration assay, hemocompatibility assay, release assay, real-time polymerase chain reaction assay, cell imaging, and anti-inflammatory assays were performed in order to characterize the three-dimensional model.

Results: The study showed that our developed system reduced the viability and migratory activity of cancer cells. Real-time polymerase chain reaction assay suggested that anti-cancer effects of our developed system may be attributed to the downregulation of Polo-Like Kinase 1 (PLK1) and Poly (ADP-Ribose) Polymerase 1 (PARP1) genes.

Conclusion: Our developed model may be used for studying the effects of different anti-cancer drugs on ovarian cancer cells.

Background: Dialysis-related amyloidosis (DRA) is a serious complication in chronic kidney disease patients on long-term dialysis, caused by β₂-microglobulin (β₂-MG) accumulation, and remains challenging owing to the growing dialysis population and extended treatment duration.

Objectives: To develop and evaluate stereocomplex poly(methyl methacrylate) (PMMA) adsorbent fibers with optimized cross-sectional and nanoporous structures for efficient, selective β₂-MG removal.

Methods: Structured PMMA fibers were fabricated via dry-wet spinning. The adsorption performance of optimized fibers was evaluated with serum containing β₂-MG and other solutes, using scanning electron microscopy (SEM), three-dimensional transmission electron microscopy (3D-TEM), and time-of-flight secondary ion mass spectrometry (TOF-SIMS). Pressure loss simulations compared fiber- and bead-packed columns.

Results: Fibers with 12-15 nm pores exhibited maximal β₂-MG adsorption. Cross-shaped fibers exhibited the highest blood-contact surface area and adsorption capacity. A thin surface-dense layer (<0.1 μm) improved β₂-MG diffusion while limiting albumin uptake. TOF-SIMS confirmed uniform β₂-MG penetration, with albumin confined near the fiber surface. Adsorption exceeded 50% for mid-weight proteins (~52 kDa), including IL-6, α₁-microglobulin (α₁-MG), and TNF-α. Pressure loss simulations showed that fiber-packed columns had lower resistance than bead-packed columns.

Conclusions: Optimized cross-shaped PMMA fibers enable efficient, selective β₂-MG removal and favorable flow dynamics for hemoperfusion therapies targeting mid-weight uremic toxins.

Background: The number of kidney dialysis patients treated by haemodiafiltration continues to increase. Previous studies have suggested that more calcium is removed during haemodiafiltration (HDF) sessions than haemodialysis (HD), particularly with pre-dilution haemodiafiltration (pre-HDF). So, we investigated whether there were differences between post-haemodiafiltration (post-HDF), pre-HDF and high flux HD treatments.

Methods: We collected a continuous aliquot of effluent dialysate during dialysis sessions, and calculated dialysis calcium mass balance by the difference between the amount of calcium delivered in fresh dialysate and that lost in effluent dialysate.

Results: Effluent dialysate was collected during 244 dialysis sessions (post-HDF (70.9%), HD (20.1%), pre-HDF (9.0%)) from 154 patients, 99 male (64.3%) median dialysis vintage of 21.4 (11.0-55.3) months. Although the total amount of calcium delivered was significantly greater with pre-HDF (168.9 (150.1-203.9) versus post-HDF (141.9 (127.2-165.1) versus HD (125.7 (119.4-127.2) mmol), as was calcium in the effluent dialysate, so the over-all sessional calcium balances were similar (pre-HDF 5.5 (-4.3 to 14), post-HDF (5.6 (-1.1 to 11.9) and HD 6.1 (-3.5 to 11.2) mmol. Calcium balance was predominantly dependent on dialysate calcium concentration (rho 0.59, p < 0.001), and in a multivariable model higher dialysate calcium concentration (odds ratio: 35,509, 95% CI: 280-4.5 × 10⁶, p < 0.001), whereas ultrafiltration lowered calcium balance (odds ratio: 0.35, 95% CI: 0.18-0.67, p = 0.002).

Conclusion: We found no difference in dialysis sessional calcium balance between the different modes. When switching patients from HD to HDF, the choice of dialysate calcium should be individualised according to bone-mineral health rather than the dialysis modality.

Introduction: Postcardiotomy shock is a condition characterized by a very high mortality rate in patients with low output following cardiac surgery. Providing mechanical circulatory support using an intra-aortic balloon pump (IABP) is one treatment option for this condition. IABP is known to have a positive hemodynamic effect on some organs. However, significant hemodynamic studies on end-organs are not yet available in the literature.

Methods: This retrospective study included 75 patients who underwent coronary artery bypass grafting (IABP) at the Cardiovascular Surgery Clinic of Konya City Hospital between December 2020 and July 2025 and underwent postcardiotomy shock. Patients were divided into two groups based on IABP location. Laboratory findings were used to analyze the hemodynamic effects of IABP location on end organs and the heart.

Results: No statistically significant differences were observed between the IABP placement site and age, BMI, duration of IABP use, or any preoperative and postoperative laboratory parameters. While the preoperative AST/ALT ratio did not differ significantly between the two groups, the postoperative AST/ALT ratio was found to be significantly higher in the supradiaphragmatic IABP placement group compared with the infradiaphragmatic IABP placement group.

Conclusion: The IABP is one of the mechanical support devices used to manage postcardiotomy shock after coronary bypass surgery. Although it is used for its beneficial effects on cardiac hemodynamics, it can also cause changes in visceral organs in some cases.

Objective: To compare the effect of hemofiltration (HF) versus hemodialysis (HD) on mortality and filter lifespan in patients with acute kidney injury (AKI).

Methods: Literature published between January 1990 and December 2025 was retrieved from four databases: PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI). Statistical analyses were performed using Review Manager (RevMan) software.

Results: Eight randomized controlled trials were included. HD showed no statistically significant difference in all-cause mortality compared to HF (RR = 1.07, 95% CI: 0.82-1.40). In subgroup analyses, continuous renal replacement therapy hemodialysis (CRRT-HD) showed no statistically significant difference in mortality compared to HF (RR = 1.05, 95% CI: 0.80-1.39; p = 0.71), nor did intermittent hemodialysis (IHD; RR = 1.19, 95% CI: 0.96-1.49; p = 0.12). Regarding filter lifespan, no significant difference was found in the overall analysis (SMD = 0.46, 95% CI: -0.29 to 1.22). However, in a single study under matched treatment doses, HD significantly prolonged filter lifespan (SMD = 1.00, 95% CI: 0.47-1.53). No significant difference was found between HDF and HF (SMD = -0.10, 95% CI: -0.37 to 0.18).

Conclusion: Current evidence shows no significant difference in mortality between HF and HD for AKI. Under matched doses, HD showed a significant advantage in prolonging filter lifespan, but this finding is based on a single study and requires confirmation. The evidence remains limited, highlighting the need for large-scale trials to assess patient-centered outcomes and operational indicators like filter lifespan.

Background: Septic shock is a life-threatening condition. Prolonged intermittent high-volume hemofiltration (HVHF) has been used as a hemodynamic support and immunomodulation strategy for patients with severe septic shock.

Methods: We studied a retrospective cohort of patients with severe septic shock who received HVHF, evaluating the response to this therapy and the factors associated with mortality.

Results: We analyzed 63 patients with severe septic shock (age 62.8 ± 13.8 years, 57.1% female, maximum SOFA 16.1 ± 3.4). Mortality was significantly associated with male sex, medical pathology at admission, chronic critical illness condition, elevated SOFA, and high doses of norepinephrine at the end of HVHF. Patients whose HVHF was performed within 24 h after surgery had lower mortality (p = 0.025). Norepinephrine dose decreased significantly with HVHF (p = 0.038). Mortality in our study was 73%, significantly lower than the predicted mortality by SOFA score: 80%-90% (p = 0.008).

Conclusion: HVHF could facilitate the management of critically ill patients with severe septic shock, especially women and surgical patients. It would allow for immunomodulation and hemodynamic support, providing time to control infection and improve the poor prognosis for these patients.

Introduction: Sepsis is a life-threatening condition characterized by organ dysfunction due to a dysregulated host response to infection. Septic shock, a severe form of sepsis, involves hypotension requiring vasopressor support and elevated lactate levels, leading to tissue hypoperfusion. Beyond standard therapy, various extracorporeal blood purification techniques have been developed to remove infectious agents and inflammatory mediators produced by the dysregulated immune response.

Materials and methods: This multicenter, retrospective observational cohort study analyzed medical records of patients hospitalized between 2021 and 2024. Patients with comparable admission timing and baseline SOFA and APACHE II scores were divided into two groups: Group 1 (no adsorptive therapy) and Group 2 (adsorptive therapy). Baseline and follow-up SOFA scores, vital signs, laboratory parameters, and culture results on days 1, 3, 5, and 10 were recorded.

Results: The overall mortality rate was 73.5% (275 ex). Crude mortality was 74.3% (139/187) in the no-filter group and 72.7% (136/187) in the filter group, with no significant difference observed (p = 0.815). Across all analytical approaches, no analysis reached statistical significance at the 0.05 level, with p-values ranging from 0.081 to 0.815. CRP, procalcitonin, and lactate levels showed a decreasing trend in both groups during treatment, with no significant differences between groups (p = 0.168, 0.322, and 0.649). Mortality did not differ significantly between early (within first 24 h) and late (>24 h) filter application groups (HR p = 0.91, p = 0.62).

Conclusion: In patients with septic shock, filters used for extracorporeal blood purification reduce the levels of inflammatory mediators. However, no effect on mortality reduction was observed.

Peritoneal dialysis (PD) is a life-sustaining treatment for end-stage kidney disease but contributes significantly to environmental degradation due to its reliance on single-use plastics, energy-intensive manufacturing and high-volume transport. Redesigning PD products for sustainability is increasingly important as healthcare systems seek to reduce their carbon footprint. In this study, ten high-use peritoneal dialysis (PD) products were redesigned using life cycle thinking. Interventions included low-carbon transport (electric vans), renewable energy and improved waste treatment (pyrolysis). Life cycle inventories (LCIs) were modelled in Open Life Cycle Assessment (OpenLCA)and modelled using cradle-to-gate carbon footprints (kg CO₂-eq) to compare redesigned and conventional versions. All redesigned products achieved carbon footprint reductions, with eight showing decreases greater than 40%. The automated PD set and 2 L dialysate bag saw reductions of 63% and 54%, respectively (saving 1.15 and 0.86 kg CO2-eq per item). The APD machine achieved the largest percentage reduction at 87%, primarily driven by the elimination of printed packaging and the use of renewable electricity. Key contributors to emissions savings across products included lower-impact transport, sustainable packaging materials and circular waste strategies. Redesigning PD products using sustainable materials and processes can deliver substantial environmental benefits without compromising functionality. These findings support evidence-based pathways for reducing emissions in kidney care through product innovation and procurement reform.

Background: Pedicle-screw-fixation (PSF) is a widely used surgical technique for stabilizing the cervical spine in cases of trauma, degenerative diseases and deformities. However, the biomechanical effects of PSF on cervical spine stability remain a topic of research.

Objective: This study employs finite-element-analysis (FEA) to investigate the influence of PSF on the cervical spine under various loading conditions.

Methods: A three-dimensional (3D) finite element model of the cervical spine (C2-C7) is developed, validated and subjected to simulated flexion, extension, lateral bending and axial rotation. Four scenarios are compared: (1) Intact spine (C2-C7), (2) spine with PSF at fourth segment (C4-C5), (3) spine with PSF at fifth segment (C5-C6) and (4) spine with two level PSF at fourth and fifth segments (C4-C6).

Results: The results demonstrate that due to single segment PSF, the total ROM (second to sixth segments) is reduced by 8.8%, 8.5%, 12.4% and 11.4% whereas two segment PSF shows that the total ROM is reduced by 24.2%, 23.3%, 23.5% and 25.3% under 1 N-m flexion, extension, lateral bending and rotations, respectively, in comparison to intact cervical spine. The maximum stresses on Titanium alloy (Ti-6Al-4V) Pedicle-screw are varied from 70 to 75 MPa and on PEEK rod are around 32-40 MPa, respectively. The maximum stresses on pedicle-screw and rod material are also below its yield stress.

Conclusion: This present FE study provides the biomechanical efficacy of cervical PSF and its impact on spinal stability for restoring cervical spine biomechanics.