Artificial Organs Research Articles

Global Scientific Trends in Continuous Renal Replacement Therapy from 2000 to 2023: A Bibliometric and Visual Analysis

Introduction: Continuous renal replacement therapy (CRRT) is one of the most widely used blood purification and organ support methods in the ICU. However, the development process, the current status, hotspots, and future trends of CRRT remain unclear. Method: The WoSCC database was used to analyze CRRT research evolution and theme trends. VOSviewer was used to construct coauthorship, co-occurrence, co-citation, and network visualizations. CiteSpace is used to detect bursts for co-occurrence items. Several important subtopics were reviewed and discussed in more detail. Results: Global publications increased from 56 in 2000 to 398 in 2023, a 710.71% increase. Blood Purification published the most manuscripts, followed by the International Journal of Artificial Organs. The USA, the San Bortolo Hospital, and Bellomo were the most productive and impactful institution, country, and author, respectively. Based on co-occurrence cluster analysis, five clusters emerged: (1) clinical applications and management of CRRT; (2) sepsis and CRRT; (3) CRRT anticoagulant management; (4) CRRT and antibiotic pharmacokinetics and pharmacodynamics; and (5) comparison of CRRT and intermittent hemodialysis. COVID-19, initiation, ECOMO, cefepime, guidelines, cardiogenic shock, biomarker, and outcome were the latest high-frequency keywords or strongest bursts, indicating the emerging frontiers of CRRT. Conclusions: There has been widespread publication and citation of CRRT research in the past 2 decades. We provide an overview of current trends, global collaboration patterns, basic knowledge, research hotspots, and emerging frontiers.

Conception and prospective multicentric validation of a Robotic Surgery Training Curriculum (RoSTraC) for surgical residents: from simulation via laboratory training to integration into the operation room

There is a lack of training curricula and educational concepts for robotic-assisted surgery (RAS). It remains unclear how surgical residents can be trained in this new technology and how robotics can be integrated into surgical residency training. The conception of a training curriculum for RAS addressing surgical residents resulted in a three-step training curriculum including multimodal learning contents: basics and simulation training of RAS (step 1), laboratory training on the institutional robotic system (step 2) and structured on-patient training in the operating room (step 3). For all three steps, learning content and video tutorials are provided via cloud-based access to allow self-contained training of the trainees. A prospective multicentric validation study was conducted including seven surgical residents. Transferability of acquired skills to a RAS procedure were analyzed using the GEARS score. All participants successfully completed RoSTraC within 1 year. Transferability of acquired RAS skills could be demonstrated using a RAS gastroenterostomy on a synthetic biological organ model. GEARS scores concerning this procedure improved significantly after completion of RoSTraC (17.1 (±5.8) vs. 23.1 (±4.9), p < 0.001). In step 3 of RoSTraC, all participants performed a median of 12 (range 5–21) RAS procedures on the console in the operation room. RoSTraC provides a highly standardized and comprehensive training curriculum for RAS for surgical residents. We could demonstrate that participating surgical residents acquired fundamental and advanced RAS skills. Finally, we could confirm that all surgical residents were successfully and safely embedded into the local RAS team.

Microencapsulation in food processing - A review study

Microencapsulation is one of the efficient, advanced and promising technologies in the field of food processing. The technology involves the protection of different valuable food constituents present in a food product by the use of a suitable covering material on it. Besides, protecting the covering material allows the release of the core material in a controlled way increases shelf life and enhances the sensory qualities. The process of microencapsulation can be done by various methods such as coacervation, polymer-polymer incompatability, solvent evaporation, spray drying, fluidized bed technology, pan coating, spinning disc, extrusion, interfacial polymerization etc. This technology is being used in various fields including pharmaceutical, vectorisation, artificial organs, single dose treatment, agriculture (fungicide, herbicide, insect repellent, artificial insemination), food, printing, cosmetic, textile and defense. No single microencapsulation process is adaptable to all core materials. It is a complicated process and requires skilled person to handle the whole process. As worldwide demands for functional coatings continue to increase, new, cost effective microencapsulation technologies will be developed and the technology will remain at the forefront of future.

Development of an Artificial Nose Using 3D Printing Technology for Patients with Tumors

A prosthetic nose is an option where the patient can gain an artificial organ for aesthetics. Thus, this study includes the 3D scan and reconstruction of the 3D model of an artificial nose and analyzes different material properties, which are thermoplastic polyurethane (TPU), thermoplastic elastomer (TPE), and nylon 6 (PA). This research aims to fabricate an artificial nose model using 3D printing technology. A 3D scanner can scan the human head before reconstructing the nose. The analysis of different materials on the artificial nose model is to determine the appropriate material for the artificial nose to fit perfectly into the patient’s face. The artificial nose will use TPU material with a deformation value of 0.00413mm and a maximum stress value of 0.4930 MPa. This prosthesis nose enables people to interact in their social and family lives, making them happier and more comfortable.

The Future for End-Stage Kidney Disease Treatment: Implantable Bioartificial Kidney Challenge

Despite limited organ availability and post-transplant complications, kidney transplantation remains the optimal treatment for End-Stage Kidney Disease (ESKD). However, innovative dialysis technologies such as portable, wearable, and implantable bioartificial kidney systems are being developed with the aim of addressing these issues and improving patient care. An ideal implantable device could combine bioreactors and blood ultrafiltration to replicate key native cell functions for solute reabsorption, secretion, and endocrinologic activities. Today, the feasibility of an implantable bioreactor for renal cell therapy opens the challenge of developing a fully implantable bioartificial kidney based on silicon nanopore membranes to ensure immunological isolation, cell viability, and the possibility of maintaining a blood substrate for metabolic activities. Current technology is not sufficient to obtain an efficient artificial bioreactor to reach physiological blood purification, which requires a more complex system to produce an ultrafiltrate from the blood that can be processed by cells and eliminated as urine. The number of cells in the bioreactor, endocrine activity, immunological cell isolation, solute and fluid secretion/reabsorption, cell viability, blood and ultrafiltration flow control, and thrombogenicity are fundamental issues that require a new technology that today appears to be a challenge for the design of an implantable artificial kidney. This review aims to analyze the state of the art in this particular field of kidney replacement therapy to highlight the current limitations and possible future technology developments to create implanted and wearable organs capable of treating ESKD with artificial organs that can replicate all native kidneys functions.

Advances in 3D bioprinting for regenerative medicine applications

Abstract Biofabrication techniques allow for the construction of biocompatible and biofunctional structures composed from biomaterials, cells and biomolecules. Bioprinting is an emerging 3D printing method which utilizes biomaterial-based mixtures with cells and other biological constituents into printable suspensions known as bioinks. Coupled with automated design protocols and based on different modes for droplet deposition, 3D bioprinters are able to fabricate hydrogel-based objects with specific architecture and geometrical properties, providing the necessary environment that promotes cell growth and directs cell differentiation towards application-related lineages. For the preparation of such bioinks, various water-soluble biomaterials have been employed, including natural and synthetic biopolymers, and inorganic materials. Bioprinted constructs are considered to be one of the most promising avenues in regenerative medicine due to their native organ biomimicry. For a successful application, the bioprinted constructs should meet particular criteria such as optimal biological response, mechanical properties similar to the target tissue, high levels of reproducibility and printing fidelity, but also increased upscaling capability. In this review, we highlight the most recent advances in bioprinting, focusing on the regeneration of various tissues including bone, cartilage, cardiovascular, neural, skin and other organs such as liver, kidney, pancreas and lungs. We discuss the rapidly developing co-culture bioprinting systems used to resemble the complexity of tissues and organs and the crosstalk between various cell populations towards regeneration. Moreover, we report on the basic physical principles governing 3D bioprinting, and the ideal bioink properties based on the biomaterials’ regenerative potential. We examine and critically discuss the present status of 3D bioprinting regarding its applicability and current limitations that need to be overcome to establish it at the forefront of artificial organ production and transplantation.

Biomaterials for Artificial Organs and Organoids- A Comprehensive review

The technological development of biomaterials used in forming artificial organs and organoids indicates a revolutionary area within biomedical engineering and the field of regenerative medicine. This study provides an in-depth review of recent progress in biomaterials, emphasizing their design and use for fabricating artificial organs and organoids. The analysis proceeds with examining the necessary parameters for biomaterials in simulating the biological and biomechanical qualities of local tissues. The next effort turns towards synthesizing and characterizing innovative biomaterials, including biocompatible polymers, hydrogels, and bioactive scaffolds that can be tailored to suit specific organ systems. The paper provides an in-depth take on the developments in 3D biological printing and microfabrication techniques, emphasizing how they facilitate the synthesis of complicated, multicellular structures. The research also examines the integration of biomaterials when combined with stem cell technologies, focusing on their role in forming organs and the prospects for customized medical treatments. This review highlights the significant developments achieved in this area and the potential of these technologies in addressing the limited supply of organs, performing drug testing, and improving knowledge of the growth of organs and diseases.

Shape of scaffold controlling the direction of cell migration.

Cell migration plays an important role in the development and maintenance of multicellular organisms. Factors that induce cell migration and mechanisms controlling their expression are important for determining the mechanisms of factor-induced cell migration. Despite progress in the study of factor-induced cytotaxis, including chemotaxis and haptotaxis, precise control of the direction of cell migration over a wide area has not yet been achieved. Success in this area would update the cell migration assays, superior cell separation technologies, and artificial organs with high biocompatibility. The present study therefore sought to control the direction of cell migration over a wide area by adjusting the three-dimensional shape of the cell scaffold. The direction of cell migration was influenced by the shape of the cell scaffold, thereby optimizing cell adhesion and protrusion. Anisotropic arrangement of these three-dimensional shapes into a periodic structure induced unidirectional cell migration. Three factors were required for unidirectional cell migration: 1) the sizes of the anisotropic periodic structures had to be equal to or lower than the size of the spreading cells, 2) cell migration was restricted to a runway approximately the width of the cell, and 3) cells had to be prone to extension of long protrusions in one direction. Because the first two factors had been identified previously in studies of cell migration in one direction using two-dimensional shaped patterns, these three factors are likely important for the mechanism by which cell scaffold shapes regulate cell migration.

Development of a novel artificial normothermic organ perfusion preservation solution and its application in DCD donor liver preservation

Development of a novel artificial normothermic organ perfusion preservation solution and its application in DCD donor liver preservation

Versatile Pickering emulsion gel lubricants stabilized by cooperative interfacial graphene oxide-polymer assemblies.

Although a large number of water- and oil-based gel lubricants have found extensive potential applications in industrial and biomedical fields, developing new-type emulsion-based gel lubricants that may effectively integrate their characteristics and preponderances remains a significant challenge. Here a water-in-oil Pickering emulsion gel lubricant that is able to combine the high colloidal stability of traditional Pickering emulsions, the good swelling and corrosion resistance of oil-based gel lubricants, and the high cooling capacity of water-based gel lubricants prepared from a binary mixture of aqueous graphene oxide (GO) dispersion and diamino-functionalized polydimethylsiloxane oil solution in a broad concentration, pH, and water volume fraction range is reported. It can provide favourable lubrication for the Si3N4/steel and Si3N4/silicone tribopairs either in air or under water owing to the formation of a sturdy adsorbed oil film and ball-bearing actions of the GO particles. It can also be printed into various colourful 2D and 3D geometries upon direct extrusion into water, thanks to its water-in-oil nature and inherent shear-thinning and thixotropic properties, which further shows good prospects in underwater operations and artificial biomimetic organs. Our study may provide new insights into the design and preparation of novel semi-solid materials for diverse industrial, engineering, and biomedical applications.

Assessing bioartificial organ function: the 3P model framework and its validation.

The rapid advancement in the fabrication and culture of in vitro organs has marked a new era in biomedical research. While strides have been made in creating structurally diverse bioartificial organs, such as the liver, which serves as the focal organ in our study, the field lacks a uniform approach for the predictive assessment of liver function. Our research bridges this gap with the introduction of a novel, machine-learning-based "3P model" framework. This model draws on a decade of experimental data across diverse culture platform studies, aiming to identify critical fabrication parameters affecting liver function, particularly in terms of albumin and urea secretion. Through meticulous statistical analysis, we evaluated the functional sustainability of the in vitro liver models. Despite the diversity of research methodologies and the consequent scarcity of standardized data, our regression model effectively captures the patterns observed in experimental findings. The insights gleaned from our study shed light on optimizing culture conditions and advance the evaluation of the functional maintenance capacity of bioartificial livers. This sets a precedent for future functional evaluations of bioartificial organs using machine learning.

From electricity to vitality: the emerging use of piezoelectric materials in tissue regeneration.

The unique ability of piezoelectric materials to generate electricity spontaneously has attracted widespread interest in the medical field. In addition to the ability to convert mechanical stress into electrical energy, piezoelectric materials offer the advantages of high sensitivity, stability, accuracy and low power consumption. Because of these characteristics, they are widely applied in devices such as sensors, controllers and actuators. However, piezoelectric materials also show great potential for the medical manufacturing of artificial organs and for tissue regeneration and repair applications. For example, the use of piezoelectric materials in cochlear implants, cardiac pacemakers and other equipment may help to restore body function. Moreover, recent studies have shown that electrical signals play key roles in promoting tissue regeneration. In this context, the application of electrical signals generated by piezoelectric materials in processes such as bone healing, nerve regeneration and skin repair has become a prospective strategy. By mimicking the natural bioelectrical environment, piezoelectric materials can stimulate cell proliferation, differentiation and connection, thereby accelerating the process of self-repair in the body. However, many challenges remain to be overcome before these concepts can be applied in clinical practice, including material selection, biocompatibility and equipment design. On the basis of the principle of electrical signal regulation, this article reviews the definition, mechanism of action, classification, preparation and current biomedical applications of piezoelectric materials and discusses opportunities and challenges for their future clinical translation.

Portuguese Advance Directives-a twist against futility? A cross sectional study.

Advance Directive documents allow citizens to choose the treatments they want for end-of-life care without considering therapeutic futility. To analyze patients' and caregivers' answers to Advance Directives and understand their expectations regarding their decisions. This study analyzed participants' answers to a previously published trial, conceived to test the document's efficacy as a communication tool. Sixty palliative patients and 60 caregivers (n=120) registered their preferences in the Advance Directive document and expressed their expectations regarding whether to receive the chosen treatments. In the patient and caregiver groups, 30% and 23.3% wanted to receive cardiorespiratory resuscitation; 23.3% and 25% wanted to receive artificial organ support; and 40% and 35% chose to receive artificial feeding and hydration, respectively. The participants ignored the concept of therapeutic futility and expected to receive invasive treatments. The concept of therapeutic futility should be addressed and discussed with both the patients and caregivers. Legal Advanced Directive documents should be made clear to reduce misinterpretations and potential legal conflicts. The authors suggest that all citizens should be clarified regarding the futility concept before filling out the Advance Directives and propose a grammatical change in the document, replacing the phrase "Health Care to Receive / Not to Receive" with the sentence "Health Care to Accept / Refuse" so that patients cannot demand treatments, but instead accept or refuse the proposed therapeutic plans. ClinicalTrials.gov ID NCT05090072. https://clinicaltrials.gov/ct2/show/NCT05090072.

Membrane-based microfluidic systems for medical and biological applications.

Microfluidic devices with integrated membranes that enable control of mass transport in constrained environments have shown considerable growth over the last decade. Membranes are a key component in several industrial processes such as chemical, pharmaceutical, biotechnological, food, and metallurgy separation processes as well as waste management applications, allowing for modular and compact systems. Moreover, the miniaturization of a process through microfluidic devices leads to process intensification together with reagents, waste and cost reduction, and energy and space savings. The combination of membrane technology and microfluidic devices allows therefore magnification of their respective advantages, providing more valuable solutions not only for industrial processes but also for reproducing biological processes. This review focuses on membrane-based microfluidic devices for biomedical science with an emphasis on microfluidic artificial organs and organs-on-chip. We provide the basic concepts of membrane technology and the laws governing mass transport. The role of the membrane in biomedical microfluidic devices, along with the required properties, available materials, and current challenges are summarized. We believe that the present review may be a starting point and a resource for researchers who aim to replicate a biological phenomenon on-chip by applying membrane technology, for moving forward the biomedical applications.

Posthumanism philosophy in nursing profession

Posthumanism represents a dynamic and continually evolving movement, positing that advancements in science and technology, over time, will lead to the displacement of humans by machines, diminishing the human role in the world [1, 2]. It contends that the core of learning encompasses diverse factors, rejecting the centrality of humanism [3]. Consequently, nursing practices must adapt to societal changes influenced by post-humanist ideals [1]. Nurses are urged to comprehend the evolving landscape of post-humanism in nursing education, research, and knowledge [4]. Within the post-humanist framework, it is asserted that nursing challenges, both current and future, can be effectively addressed through interactive and collaborative approaches between nurses and patients [5]. This post-humanist perspective significantly impacts health performance, particularly in nursing and rehabilitation nursing, emphasizing the advancement of nursing care [6, 7]. Recognition of human and non-human relationships becomes imperative in nursing, considering the continuous progression of science and technology [8]. The rapid advancements in science and technology have introduced the capability for individuals to select desirable traits for their offspring through genetic manipulation and consider artificial organs for various medical conditions [3]. Consequently, nursing in the post-humanist era necessitates an adaptation to living in harmony with the growth and development of artificial intelligence [9]. Nurses are called upon to contribute to societal empowerment aligned with emerging technologies [10]. In the era of posthumanism, nurses assume a crucial role characterized by effective interaction, understanding of prevailing conditions, and the application of critical thinking and creativity in nursing care. Traditional solutions may prove inadequate in addressing novel conditions and situations, emphasizing the need for nurses to make informed decisions based on evidence-based decision-making [3]. Therefore, an essential requirement is nursing education that emphasizes evidence-based decision-making and the cultivation of critical thinking skills.

Development and evaluation of artificial organ models for ERCP training in patients with surgically altered anatomies

Endoscopy training models (ETM) using artificial organs are practical, hygienic and comfortable for trainees. However, few models exist for training endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered anatomy. This training is necessary as the number of bariatric surgeries performed worldwide increases. ETM with human-like anatomy were developed to represent the postoperative anatomy after Billroth II (BII) reconstruction for a standard duodenoscope and the situs of a long-limbed Roux-en-Y (RY) for device-assisted enteroscopy (DAE). In three independent workshops, the models were evaluated by international ERCP experts. In RY model, a simulation for small bowel behavior in endoscopy was created. Thirty-three experts rated the ETM in ERCP expert courses. The BII model was evaluated as suitable for training (school grades 1.36), with a haptic and visual impression rating of 1.73. The RY model was rated 1.50 for training suitability and 2.06 for overall impression. Animal tissue-free ETMs for ERCP in surgically altered anatomy were successfully created. Evaluation by experienced endoscopists indicated that the models are suitable for hands-on ERCP training, including device-assisted endoscopy. It is expected that patient care will improve with appropriate training in advanced procedures.

Techniques and applications of 3D bioprinting

3D bioprinting is an emerging technology that uses computer printing technology and unique bio-ink components to create artificial organs and biomedical objects. It is an interdisciplinary development technology integrating biology, chemistry, materials science, life science and other disciplines, and the technology behind biological 3D printing has improved in its development over the past few decades. Precisely printed biomaterials could benefit both tissue engineering and regenerative medicine. 3D bioprinting technology makes it possible to print tissues and organs, providing favorable conditions for organ transplantation and medical experiments. This paper mainly reviews the development of bioprinting technology and related concepts. According to the morphological change and chemical composition, the commonly used bioprinting materials (bio-inks) and their characteristics are described. The main methods of bioprinting are summarized, including traditional inkjet 3D bioprinting, extrusion 3D bioprinting, laser-assisted 3D bioprinting, photocuring 3D bioprinting and emerging 4D bioprinting and in situ bioprinting technologies. Finally, the paper introduces the development trend of bioprinting in the transplantation of skin, blood vessels and complex organs, as well as the precision research of tumors. In addition, current research challenges and prospects for future bioprinted 3D printing materials are discussed.

An arteriovenous mock circulatory loop and accompanying bond graph model for invitro study of peripheral intravascular bioartificial organs.

Silicon nanopore membrane-based implantable bioartificial organs are dependent on arteriovenous implantation of a mechanically robust and biocompatible hemofilter. The hemofilter acts as a low-resistance, high-flow network, with blood flow physiology similar to arteriovenous shunts commonly created for hemodialysis access. A mock circulatory loop (MCL) that mimics shunt physiology is an essential tool for refinement and durability testing of arteriovenous implantable bioartificial organs and silicon blood-interfacing membranes. We sought to develop a compact and cost-effective MCL to replicate flow conditions through an arteriovenous shunt and used data from the MCL and swine to inform a bond graph mathematical model of the physical setup. Flow physiology through bioartificial organ prototypes was obtained in the MCL and during extracorporeal attachment to swine for biologic comparison. The MCL was tested for stability overtime by measuring pressurewave variability over a 48-h period. Data obtained invitro and extracorporeally informed creation of a bond graph model of the MCL. The arteriovenous MCL was a cost-effective, portable system that reproduced flow rates and pressures consistent with a pulsatile arteriovenous shunt as measured in swine. MCL performance was stable over prolonged use, providing a cost-effective simulator for enhanced testing of peripherally implanted bioartificial organ prototypes. The corresponding bond graph model recapitulates MCL and animal physiology, offering a tool for further refinement of the MCL system.

High-Resolution Additive Manufacturing of a Biodegradable Elastomer with A Low-Cost LCD 3D Printer.

Artificial organs and organs-on-a-chip (OoC) are of great clinical and scientific interest and have recently been made by additive manufacturing, but depend on, and benefit from, biocompatible, biodegradable, and soft materials. Poly(octamethylene maleate (anhydride) citrate (POMaC) meets these criteria and has gained popularity, and as in principle, it can be photocured and is amenable to vat-photopolymerization (VP) 3D printing, but only low-resolution structures have been produced so far. Here, a VP-POMaC ink is introduced and 3D printing of 80µm positive features and complex 3D structures is demonstrated using low-cost (≈US$300) liquid-crystal display (LCD) printers. The ink includes POMaC, a diluent and porogen additive to reduce viscosity within the range of VP, and a crosslinker to speed up reaction kinetics. The mechanical properties of the cured ink are tuned to match the elastic moduli of different tissues simply by varying the porogen concentration. The biocompatibility is assessed by cell culture which yielded 80% viability and the potential for tissue engineering illustrated with a 3D-printed gyroid seeded with cells. VP-POMaC and low-cost LCD printers make the additive manufacturing of high resolution, elastomeric, and biodegradable constructs widely accessible, paving the way for a myriad of applications in tissue engineering and 3D cell culture as demonstrated here, and possibly in OoC, implants, wearables, and soft robotics.

Developments and challenges of liver transplantation in China

With the vigorous promotion of organ donation after citizen death in China, increased utilization of marginal livers, and continuous expansion of hepatocellular carcinoma indications for liver transplantation, innovations in techniques such as auxiliary liver transplantation, pediatric liver transplantation laparoscopic liver transplantation, magnetic liver transplantation,and non-ischemic liver transplantation have significantly improved the number of liver transplantation surgery performed, patient survival rates, and graft survival rates in China, while complication rates have gradually decreased. As such,liver transplantation in China has now reached leading or advanced levels internationally. In the new development context,Chinese liver transplantation faces new opportunities and challenges for development. Evolutions in basic diseases of transplant recipients and tumor classifications of will further broaden the population eligible for transplantation and introduce new demands for liver transplantation procedures. Emerging technologies including artificial organs, xenotransplantation,and artificial intelligence are bringing prospects for advancing liver transplantation. Looking ahead, the progression of liver transplantation will go beyond prioritizing patient survival rates and graft survival rates alone, instead emphasizing improved quality of life for transplant recipients post-surgery to an even greater extent.