Continuous intradialytic amino acid infusion from the start of dialysis is better to avoid catabolism under the high-volume pre-dilution on-line HDF
AbstractIt was reported that amino acid infusion during hemodialysis is useful for improving nutritional status. The optimal administration method of amino acid infusion under the high-volume pre-dilution on-line HDF (HVPO-HDF) was analyzed in this study. Subjects were 10 patients on maintenance dialysis at our clinic. We performed high-volume pre-dilution on-line HDF. We investigated two methods for administration of Neoamiyu® 200-ml total amino acid (TAA) infusion for patients with renal failure: (1) continuous infusion into the dialysis circuit for 4 h from the start of dialysis to its completion (infusion rate 50 m...
Source: Journal of Artificial Organs - February 28, 2022 Category: Transplant Surgery Source Type: research
Hemoadsorption with CytoSorb ® and the early course of linezolid plasma concentration during septic shock
We present the case of a 61-year-old female patient with known Ulrich Turner syndrome who treated supportively with CytoSorb® and with linezolid due to a Staphylococcus epidermidis bloodstream infection as part of her intensive care treatment for septic shock. After establishment of a new adsorber, 600 mg of linezolid administered over 1 h. Linezolid levels measured before adsorber inlet (cpre) and after adsorber outlet (cpost) at 0, 15, 60, 120 and 480 min after starting infusion. Out of the ten samples, only the cpre samples 60 min (3.25 mg/l) and 120 min (4.7 mg/l) showed sufficiently high linezolid levels (th...
Source: Journal of Artificial Organs - February 24, 2022 Category: Transplant Surgery Source Type: research
Replication of fouling in vitro in hollow fiber dialyzers by albumin immobilization
AbstractFor designing and evaluating the dialyzer and investigating the optimal therapeutic conditions, in vitro studies bring us many useful findings. In hemodialysis, however, the membrane fouling due to protein molecules reduces solute removal performance. Therefore, we investigated a method for replicating the fouling in dialyzers in aqueous experiments. After the albumin solution was circulated in the test circuit with a dialyzer, a glutaraldehyde solution was pumped into the dialyzer to immobilize albumin on the hollow fiber membrane. Under various immobilization conditions, the permeability of creatinine and vitamin...
Source: Journal of Artificial Organs - February 11, 2022 Category: Transplant Surgery Source Type: research
Hemodynamic performance of INSPIRIS RESILIA aortic bioprosthesis for severe aortic stenosis: 2-year follow-up in Japanese cohort
AbstractThe INSPIRIS RESILIA aortic bioprosthesis (Edwards Lifesciences LLC, Irvine, USA) was fixed in novel tissue preservation technology to ensure long-term durability. Hemodynamic performance after aortic valve replacement (AVR) for severe aortic stenosis (AS) has not been published in the Japanese cohort. Twenty-nine patients underwent AVR with INSPIRIS RESILIA bioprosthesis for severe AS between November 1, 2018 and December 31, 2020. The mean age was 75.1 ± 4.5 years with 19 female patients. Body surface area was 1.58 ± 0.19 m2 and New York Heart Association functional class was 2.2 ± 0.5. Hemodyna...
Source: Journal of Artificial Organs - February 7, 2022 Category: Transplant Surgery Source Type: research
Methods for confirming the safety of radiation therapy in patients with left ventricular assist device: a case of extranodal NK/T-cell lymphoma, nasal type
AbstractA left ventricular assist device (LVAD) is a treatment option for patients with end-stage heart failure; however, a certain number of patients on durable LVADs are diagnosed with malignancy. Radiation therapy (RT) for patients with durable LVADs has safety concerns, because RT may interfere with the device. Herein, we report a case of RT during durable LVAD management. A 48-year-old man with a durable LVAD was diagnosed with sinusitis. As his symptoms were resistant to drug therapy, endoscopic sinus surgery was performed, and extranodal NK/T-cell lymphoma, nasal type (ENKL) was pathologically detected. Since RT was...
Source: Journal of Artificial Organs - February 3, 2022 Category: Transplant Surgery Source Type: research
Anterior leaflet-oriented tricuspid annuloplasty using a flexible ring for severe tricuspid regurgitation
We describe our concept and method of tricuspid annuloplasty using flexible ring for patients with severe tricuspid regurgitation accompanied by a severe tethering and a wide separation of the leaflets between the anterior leaflet and septal leaflet. The goal for our tricuspid ring annuloplasty using a flexible ring is to match the patient ’s own anterior leaflet configuration. We reduce the size of the tricuspid annulus respecting the individual configuration of the anterior leaflet to create a sufficient coaptation area of the leaflets. We performed this method in a 78-year-old female patient with very severe tricuspid...
Source: Journal of Artificial Organs - February 2, 2022 Category: Transplant Surgery Source Type: research
Advances in tissue engineering technology for kidney regeneration and construction
AbstractTissue engineering is a highly interdisciplinary research field aiming at repairing, replacing, and regenerating the defective tissues. Over several decades of research, a variety of methods have been developed. The technical methods can be categorized into scaffold-based and scaffold-free strategies. In this mini review, the discussion will be focused on the technical methods of tissue engineering for kidney regeneration and construction. (Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - January 31, 2022 Category: Transplant Surgery Source Type: research
Impact of gap size and groove design of hydrodynamic bearing on plasma skimming effect for use in rotary blood pump
AbstractPlasma skimming can exclude red blood cells from high shear regions in the gaps formed by hydrodynamic bearings in rotary blood pumps. We investigated the effect of the gap size and groove design on the plasma skimming efficiency. Spiral groove bearings (SGBs) were installed into a specially designed test rig for in vitro experiments performed using human blood. The measured gap between the ridges of the bearing and the rotor surface was 17 –26 µm at a flow rate of 150 ml/min and a rotor speed of 2400 rpm. Three different patterns of SGBs were designed (SGB-0, SGB-30, and SGB-60) with various degrees of the c...
Source: Journal of Artificial Organs - January 28, 2022 Category: Transplant Surgery Source Type: research
Flexion limitation of the Impella 5.0 when implanted using the femoral approach in patients with small stature
(Source: Journal of Artificial Organs)
Source: Journal of Artificial Organs - January 24, 2022 Category: Transplant Surgery Source Type: research
Transcatheter closure of patent foramen ovale accompanying right-to-left shunt during Impella support
AbstractWe experienced a 65-year-old woman who was diagnosed as fulminant myocarditis and transferred on mechanical ventilator and veno-arterial extracorporeal membrane oxygenation (ECMO) supports. Impella 5.0 support was additionally initiated to improve pulmonary edema and unload left ventricle. We found a patent foramen ovale (PFO) at the time of Impella insertion by transesophageal echocardiography. Follow-up transesophageal echocardiography found a development of right-to-left shunt flow through PFO accompanying central hypoxia during Impella P8 support. Veno-arterial ECMO was converted to veno-arterio-venous ECMO and...
Source: Journal of Artificial Organs - January 22, 2022 Category: Transplant Surgery Source Type: research
Usefulness of hybrid veno-arterial extracorporeal membrane oxygenation for lung ischemia –reperfusion injury after biventricular assist device implantation
AbstractWe experienced a case of fulminant myocarditis complicated by severe lung ischemia –reperfusion injury after switching from veno-arterial extracorporeal membrane oxygenation to biventricular assist device. We controlled lung blood flow by hybrid veno-arterial extracorporeal membrane oxygenation, which was established by modifying the biventricular assist device circuit without r esternotomy, blood delivery to the pulmonary artery and blood removal from the left ventricle in addition to central veno-arterial extracorporeal membrane oxygenation, and accelerated lung recovery. The patient’s lung damage and cardiac...
Source: Journal of Artificial Organs - January 21, 2022 Category: Transplant Surgery Source Type: research
Fracture of dual lumen cannula leading to cerebrovascular accident in a patient supported with ECMO
AbstractExtended duration extracorporeal membrane oxygenation (ECMO), using dual-lumen cannulas, is being used with increased frequency to support patients, including those with COVID-19; both as a bridge to transplant and lung recovery. During such an extended duration of support, there are several factors that might lead to the attrition of the physical structure of the ECMO cannulas, predisposing them to the risk of fracture. Although rare, fracture of the ECMO cannula can be a potentially lethal event. Here, we present a case where fracture of a dual lumen cannula during veno-venous (VV) ECMO support resulted in a cere...
Source: Journal of Artificial Organs - January 18, 2022 Category: Transplant Surgery Source Type: research
Single-pass albumin dialysis and hemoadsorption for bilirubin and bile acids removal for a child with hyperbilirubinemia after ventricular assist device implantation
We report the successful management of hyperbilirubinemia using two different modalities of extracorporeal bilirubin removal therapy for a pediatric patient. A 13-year-old boy with dilated cardiomyopathy requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) developed acute kidney injury and was dependent on continuous renal replacement therapy. He developed hyperbilirubinemia with a peak total bilirubin level of 786 μmol/L after implantation of biventricular assist device (BiVAD). Extracorporeal bilirubin and bile acids removal using single-pass albumin dialysis (SPAD) with 4% albumin as dialysate brough...
Source: Journal of Artificial Organs - January 17, 2022 Category: Transplant Surgery Source Type: research
Impact of sleep-disordered breathing on ventricular tachyarrhythmias after left ventricular assist device implantation
AbstractSleep-disordered breathing (SDB) is associated with an increased risk of adverse events in patients with heart failure (HF); however, its impact in patients implanted with a left ventricular assist device (LVAD) remains unclear. We aimed to investigate the prevalence of SDB in patients with LVAD and its impact on their clinical outcomes. Fifty consecutive patients with LVAD who underwent portable sleep monitoring between September 2017 and April 2018 were prospectively enrolled, and they were followed up for 170 ± 36 days. According to their respiratory disturbance indexes (RDIs), they were categorized into ...
Source: Journal of Artificial Organs - January 13, 2022 Category: Transplant Surgery Source Type: research
Bridge from central extracorporeal life support is a risk factor of cerebrovascular accidents after durable left ventricular assist device implantation
This study enrolled 158 consecutive patients who had either the HeartMate II or HeartMate 3 and were implanted for bridge-to-transplantation. These devices were implanted as the primary mechanical support device in 115 patients, whereas the remaining 43 underwent LVAD implantation as the bridge from central ECLS. The primary study endpoint was all-cause mortality and cerebrovascular accidents (CVAs) after durable LVAD implantation, and the secondary endpoints were adverse events. Overall survival was not significantly different between the two groups. In contrast, the probability of CVAs was significantly greater in the br...
Source: Journal of Artificial Organs - December 6, 2021 Category: Transplant Surgery Source Type: research
