International Journal of Artificial Organs最新文献

Background: Protein adsorption on medical devices in contact with blood is a significant issue during renal replacement therapy. Main forces determining fouling are the electrostatic interactions between membrane and charged protein, but the dialysis membrane surface charges can be adjusted by modifying the polymer matrix to decrease the blood plasma protein adsorption.

Methods: In this study, polysulfone membranes (PSU) were modified by incorporation of carbon nanoparticles such as: multiwall carbon nanotubes (2 wt.% MWCNT), graphene oxide (1 wt.% GO), and graphite (5 wt.% GR) during manufacturing process (nonsolvent-induced phase separation, NIPS). The PSU flat sheet membrane was the reference sample.

Results: Observed morphology of nanocomposite membranes was similar (SEM imaging); all of them had finger-like pore structure with unimodal distribution of pore size and similar skin-to-support ratio (1:3). The carbon nanoadditives also influenced the surface wettability: hydrophobicity and surface free energy of membranes increased (polar components of energy were reduced, while the dispersive components were increased).

Conclusion: The surface charge of nanocomposite membranes increased, when the polymer matrix has been modified with CNT or GR. This significantly affects the adsorption of proteins such as chicken (CSA) and bovine serum albumin (BSA) and reduces blood clotting on the membrane.

Objective: To construct a prediction model of coagulation in the extracorporeal circulation circuit during hemodialysis with regional citrate anticoagulant(RCA) conditions.

Methods: This was a single-center, retrospective study. The clinical data of patients who received hemodialysis with RCA from February 2021 to March 2022 were collected. The risk predictors of coagulation in the extracorporeal circulation circuit were screened by LASSO regression. On this basis, we used multivariate logistic regression analysis to establish a nomogram prediction model.

Results: A total of 98 patients received RCA hemodialysis for 362 times. Among them, 155 treatments with complete data were included in the study. Among the 155 treatments, coagulation of the extracorporeal circulation circuit occurred 12 times. The use of arteriovenous fistulas(AVF), the venous pressure at 4 h after hemodialysis initiation, blood flow velocity, dialyzer manufacturer, Systemic iCa²⁺ at 1 h after hemodialysis initiation, plasma albumin level, and plasma d-dimer level were influencing factors of coagulation in the extracorporeal circuit during hemodialysis with RCA (p < 0.05). A nomogram model was made out of the above indicators. The area under the receiver operating characteristic (ROC) curve for predicting coagulation in the circuit was 0.967 (95% CI: 0.935-0.998). The internal validation result of the memory testing (bootstrap method) showed that the area under the ROC curve was 0.967 (95% CI: 0.918-0.991).

Conclusion: The nomogram model has good discrimination and calibration and can intuitively and succinctly predict the risk of coagulation in the extracorporeal circulation circuit during hemodialysis with RCA.

Aim: The optimal preparation conditions of Salmon decalcified bone matrix (S-DBM) were explored, and the properties of S-DBM bone particles and bone powder were studied respectively. The therapeutic effect of S-DBM on tibial defect in female Sprague Dawley (SD) rats was preliminarily verified.

Methods: This study assessed the structural and functional similarities of Salmon bone DBM (S-DBM). The biocompatibility assessment was conducted using both in vivo and in vitro experiments, establishing an animal model featuring tibial defects in rats and on the L929 cell line, respectively. The control group, bovine DBM (bDBM), was compared to the S-DBM-treated tibial defect rats. Imaging and histology were used to study implant material changes, defect healing, osteoinductive repair, and degradation.

Results: The findings of our study indicate that S-DBM exhibits favorable repairing effects on bone defects, along with desirable physicochemical characteristics, safety, and osteogenic activity.

Conclusions: The S-DBM holds significant potential as a medical biomaterial for treating bone defects, effectively fulfilling the clinical demands for materials used in bone tissue repair engineering.

Thromboembolic complications still arise on blood contacting surfaces. Surface charge and topography influence the subsequent deposition of proteins and platelets, potentially leading to thrombi. Research showed a correlation of surface charge and nanoscale roughness, and a negative surface charge as well as a smooth surface finish are associated with lower thrombogenicity. The aim of this study was to compare the platelet adhesion on titanium with different nanoscale roughnesses and to examine if those roughness variations caused a change in surface charge. Titanium samples were polished and roughened to four different nanoscale roughness levels. Platelet adhesion (covered surface area (CSA), N = 8) was tested in flow chambers with human whole blood using fluorescence imaging. ζ-potential was measured over a broad range of pH-values and interpolated to obtain the ζ-potential for pH_Blood (7.4). Platelet adhesion tests were evaluated in terms of p-values and the Wilcoxon test effect size and the trend of the ζ-potential at pH_Blood and the CSA was compared. R_a-values ranged between 35 (polished) and 156 nm. Regarding platelet adhesion, the polished sample showed the lowest mean CSA with a medium or strong effect size compared to the roughened samples. The interpolated ζ-potentials for pH_Blood follow a similar trend as the CSA, with the lowest ζ-potential measured for the polished surface. These findings suggest that the decreasing ζ-potential due to lower nanoscale roughness might be an additional explanation for the improved hemocompatibility besides the smoother topography.

Mechanical forces related to blood pressure and flow patterns play a crucial role in vascular homeostasis. Perturbations in vascular stresses and strain resulting from changes in hemodynamic may occur in pathological conditions, leading to vascular dysfunction as well as in vascular prosthesis, arteriovenous shunt for hemodialysis and in mechanical circulation support. Turbulent-like blood flows can induce high-frequency vibrations of the vessel wall, and this stimulus has recently gained attention as potential contributors to vascular pathologies, such as development of intimal hyperplasia in arteriovenous fistula for hemodialysis. However, the biological response of vascular cells to this stimulus remains incompletely understood. This review provides an analysis of the existing literature concerning the impact of high-frequency stimuli on vascular cell morphology, function, and gene expression. Morphological and functional investigations reveal that vascular cells stimulated at frequencies higher than the normal heart rate exhibit alterations in cell shape, alignment, and proliferation, potentially leading to vessel remodeling. Furthermore, vibrations modulate endothelial and smooth muscle cells gene expression, affecting pathways related to inflammation, oxidative stress, and muscle hypertrophy. Understanding the effects of high-frequency vibrations on vascular cells is essential for unraveling the mechanisms underlying vascular diseases and identifying potential therapeutic targets. Nevertheless, there are still gaps in our understanding of the molecular pathways governing these cellular responses. Further research is necessary to elucidate these mechanisms and their therapeutic implications for vascular diseases.

Introduction: Intra-dialytic hypotension (IDH) remains the commonest problem associated with routine haemodialysis treatments. Fluid shifts from intracellular(ICW) and extracellular(ECW) compartments to refill plasma volume during haemodialysis with ultrafiltration.

Methods: We studied the effect of relative changes in ICW and ECW indifferent body segments using multifrequency segmental bioimpedance during haemodialysis and IDH episodes.

Results: Of 42 haemodialysis patients,16 patients (38.1%) developed IDH within the first hour of dialysis. Patients with and without early IDH were well-matched for demographics and starting bioimpedance measurements. However, after 60 min, the relative change in in ECW/ICW ratio between the non-fistula arm and leg was significantly different for the early IDH group median -1.07 (-3.33 to 0.8) versus 0.61 (-0.78 to 1.8), p < 0.05, whereas there no differences in ultrafiltration rate, relative blood volume monitoring or on-line clearance.

Conclusion: Monitoring serial changes in fluid status in different body compartments with bioimpedance may potentially prevent IDH in the future.

Thick honeycomb-like electrospun scaffold with nanoparticles of hydroxyapatite (nHA) recently demonstrated its potential to promote proliferation and differentiation of a murine embryonic cell line (C3H10T1/2) to osteoblasts. In order to distinguish the respective effects of the structure and the composition on cell differentiation, beads-on-string fibers were used to manufacture thick honeycomb-like scaffolds without nHA. Mechanical and biological impacts of those beads-on string fibers were evaluated. Uniaxial tensile test showed that beads-on-string fibers decreased the Young Modulus and maximal stress but kept them appropriate for tissue engineering. C3H10T1/2 were seeded and cultured for 6 days on the scaffolds without any growth factors. Viability assays revealed the biocompatibility of the beads-on-string scaffolds, with adequate cells-materials interactions observed by confocal microscopy. Alkaline phosphatase staining was performed at day 6 in order to compare the early differentiation of cells to bone fate. The measure of stained area and intensity confirmed the beneficial effect of both honeycomb structure and nHA, independently. Finally, we showed that honeycomb-like electrospun scaffolds could be relevant candidates for promoting bone fate to cells in the absence of nHA. It offers an easier and faster manufacture process, in particular in bone-interface tissue engineering, permitting to avoid the dispersion of nHA and their interaction with the other cells.

Introduction: The hydrogen ion (H⁺) mobilization model has been previously shown to provide a quantitative description of intradialytic changes in blood bicarbonate (HCO₃) concentration during hemodialysis (HD). The current study evaluated the accuracy of different methods for estimating the H⁺ mobilization parameter (H_m) from this model.

Methods: The study compared estimates of the H⁺ mobilization parameter using predialysis, hourly during the HD treatment, and postdialysis blood HCO₃ concentrations (H_m-full2) with those determined using only predialysis and postdialysis blood HCO₃ concentrations assuming steady state conditions (H_m-SS2) during the midweek treatment in 24 chronic HD patients treated thrice weekly.

Results: Estimated H_m-full2 values (0.163 ± 0.079 L/min [mean ± standard deviation]) were higher than, but not statistically different (p = 0.067) from, those of H_m-SS2 (0.152 ± 0.065 L/min); the values of H_m-full2 and H_m-SS2 were highly correlated with a correlation coefficient of 0.948 and a mean difference that was small (0.011 L/min). Further, the H⁺ mobilization parameter values calculated using only predialysis and postdialysis blood HCO₃ concentrations during the first and third HD treatments of the week were not different from those calculated during the midweek treatment.

Conclusions: The H⁺ mobilization model can be used to provide estimates of the H⁺ mobilization parameter without the need to measure hourly intradialytic blood HCO₃ concentrations.

Previously, we found analytic solutions for single ventricular system based on the lumped parameter model (LPM). In this study, we generalized the method to biventricular system and derived its analytic solutions. LPM is just a set of differential equations, but it is difficult to solve due to time-varying ventricular elastance and high order. Mathematically, there exist no elementary solutions for time-varying equations. It turns out that instead of differential equations, according to volume conservation, a set of algebraic equations can be carried out. The solutions of the set of equations are just physiological states at end of systolic and diastolic phases such as end systolic/diastolic pressure/volume of left ventricle. As a preliminary application, the method is utilized to deduce the hemodynamic effects of VA ECMO. Left ventricular (LV) distension, a serious complication of VA ECMO, is usually attributed to factors such as increased afterload, inadequate LV unloading, reduced myocardial contractility or aortic valve regurgitation (AR), bronchial and Thebesian return in the absence of aortic valve (AoV) opening. Among these, reduced contractility and AR are strongly associated with LV distension. However, in the absence of reduced contractility or AR, it is less clear whether increased afterload or inadequate LV unloading alone can cause LV distension. This leads to the critical question: under what conditions does LV distension occur in the absence of reduced contractility or AR? The analytic formulas derived in this study give conditions for LV distension. Furthermore, the results show that the analytic hemodynamics are coincident with simulated results.

Cardiovascular diseases, particularly myocardial infarction, have significant healthcare challenges due to the limited regenerative capacity of injured heart tissue. Cardiac tissue engineering (CTE) offers a promising approach to repairing myocardial damage using biomaterials that mimic the heart's extracellular matrix. This study investigates the potential of graphene nanopowder (Gnp)-enhanced polycaprolactone (PCL) scaffolds fabricated via electrospinning to improve the properties necessary for effective cardiac repair. This work aimed to analyze scaffolds with varying graphene concentrations (0.5%, 1%, 1.5%, and 2% by weight) to determine their morphological, chemical, mechanical, and biocompatibility characteristics. The results presented that incorporating graphene improves PCL scaffolds' mechanical properties and cellular interactions. The optimal concentration of 1% graphene significantly enhanced mechanical properties and biocompatibility, promoting cell adhesion and proliferation. These findings suggest that Gnp-enhanced PCL scaffolds at this concentration can serve as a potent substrate for CTE providing insights into designing more effective biomaterials for myocardial restoration.