ASAIO JOURNAL 处于人工器官研发的前沿。在创新技术的最前沿，它以最高质量的同行评审文章为特色，描述了研究、开发、人工器官装置设计的最新进展以及初步测试的结果。 ASAIO 期刊双月刊，收录最先进的调查、实验室和临床试验，以及来自世界各地专家的讨论和意见。美国人工内脏器官协会的官方出版物。

The ASAIO Journal is at the forefront of artificial organ development, focusing on innovative technologies. This journal features high-quality peer-reviewed articles that cover the latest advancements in research, development, design of artificial organ devices, and preliminary testing results. The ASAIO Journal is a bi-monthly publication that includes cutting-edge investigations, laboratory and clinical trials, as well as discussions and opinions from experts around the world. It is the official publication of the American Society for Artificial Internal Organs.

ASAIO Journal 处于人工器官研发的前沿，专注于创新技术。该期刊以高质量的同行评审文章为特色，涵盖了研究、开发、人工器官装置设计的最新进展以及初步测试的结果。ASAIO Journal 是双月刊，收录最先进的调查、实验室和临床试验，并提供来自全球专家的讨论和意见。它是美国人工内脏器官协会的官方出版物。

ASAIO Journal

Disclaimer: This guideline describes prolonged extracorporeal life support (ECLS) and extracorporeal membrane oxygenation (ECMO), applicable to Pediatric respiratory failure. These guidelines describe useful and safe practice, prepared by ELSO and based on extensive experience and are considered consensus guidelines. These guidelines are not intended to define standard of care and are revised at regular intervals as new information, devices, medications, and techniques become available.

Christina Maratta

Renee M. Potera

Grace van Leeuwen

Andrés Castillo Moya

Lakshmi Raman

Gail M. Annich

Extracorporeal Life Support Organization (ELSO): 2020 Pediatric Respiratory ELSO Guideline

体外生命支持组织（ELSO）：2020年儿科呼吸ELSO指南

Roberto Lorusso

Kiran Shekar

Graeme MacLaren

Matthieu Schmidt

Vincent Pellegrino

Bart Meyns

Jonathan Haft

Leen Vercaemst

Federico Pappalardo

Christian Bermudez

Jan Belohlavek

Xiaotong Hou

Udo Boeken

Roberto Castillo

Dirk W. Donker

Darryl Abrams

Marco Ranucci

Kasia Hryniewicz

Ivan Chavez

Yih-Sharng Chen

Leonardo Salazar

Glenn Whitman

ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients

成人心脏患者静脉动脉体外膜氧合的ELSO临时指南

Refractory ventricular tachycardia (VT) and electrical storm are frequently associated with hemodynamic compromise requiring mechanical support. This study sought to review the current literature on the use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for hemodynamic support during VT ablation. This was a systematic review of all published literature from 2000 to 2019 evaluating patients with VT undergoing ablation with VA-ECMO support. Studies that reported mortality, safety, and efficacy outcomes in adult (&gt;18 years) patients were included. The primary outcome was short-term mortality (intensive care unit stay, hospital stay, or ≤30 days). The literature search identified 4,802 citations during the study period, of which seven studies comprising 867 patients met the inclusion criteria. Periprocedural VA-ECMO was used in 129 (15%) patients and all were placed peripherally. Average inducible VTs were 2–3 per procedure and ablation time varied between 34 mins and 4.7 hours. Median ages were between 61 and 68 years with 93% males. Median duration of VA-ECMO varied between 140 minutes and 6 days. Short-term mortality was 15% (19 patients), with the most frequent causes being refractory VT, cardiac arrest, and acute heart failure. All-cause mortality at the longest follow-up was 25%. Major bleeding, vascular/access complications, limb ischemia, stroke, and acute kidney injury were reported with varying frequency of 1–6%. In conclusion, VA-ECMO is used infrequently for hemodynamic support for VT ablation. Further data on patient selection, procedural optimization, and clinical outcomes are needed to evaluate the efficacy of this strategy.

Saraschandra Vallabhajosyula

Saarwaani Vallabhajosyula

Vaibhav R. Vaidya

Sri Harsha Patlolla

Viral Desai

Siva K. Mulpuru

Peter A. Noseworthy

Suraj Kapa

Alexander C. Egbe

Bernard J. Gersh

Abhishek J. Deshmukh

Venoarterial Extracorporeal Membrane Oxygenation Support for Ventricular Tachycardia Ablation: A Systematic Review

心室颤动消融的静脉动脉体外膜肺氧合支持：一项系统综述

Extracorporeal membrane oxygenation (ECMO) can be lifesaving but suffers from high rates of bleeding and repeated transfusions. Current monitoring of blood cell damage during ECMO is limited to platelet counts, hematocrit, and plasma hemoglobin levels. Extracelluar vesicles (EV) are small cell fragments released when cells are activated/injured. The objective was to evaluate flow cytometric measurements of EV during ECMO as an indication of platelet, red cell, and endothelial activation/injury. Samples were collected from 55 patients (1 day to 19 years) during 58 ECMO runs. ECMO activated or injured blood cells, but the extent was highly variable and patient dependent. On average platelet activation was increased sevenfold during ECMO with up to 60-fold increased activation during the first 24 hours in some patients. EV associated with platelet and red-cell injury were increased eightfold on average but up to 200-fold in patients with disseminated intravascular coagulation, severe hemolysis, or massive transfusion. Approximately 9% of ECMO patients showed a red-cell and endothelial activation pattern that was associated with poor prognosis. Extracellular vesicles with autofluorescence similar to bilirubin appeared to come from monocytes processing hemoglobin. ECMO is associated with a highly variable, sustained increase in platelet, red-cell, and endothelial activation and injury that is a combination of circuit and transfusion related events, the patients underlying condition and possibly genetic influences on blood cell activation and injury. Extracellular vesicle measurements may improve our understanding of cellular activation and injury during ECMO as we work to improve the biocompatibility of these systems.

Wayne L. Chandler

Platelet, Red Cell, and Endothelial Activation and Injury During Extracorporeal Membrane Oxygenation

体外膜肺氧合期间血小板、红细胞和内皮细胞的激活与损伤

Donation after circulatory death (DCD) livers face increased risks of critical complications when preserved with static cold storage (SCS). Although machine perfusion (MP) may mitigate these risks, its cost and logistical complexity limit widespread application. We developed the Dynamic Organ Storage System (DOSS), which delivers oxygenated perfusate at 10°C with minimal electrical power requirement and allows real-time effluent sampling in a portable cooler. In a porcine DCD model, livers were preserved using DOSS or SCS for 10 hours and evaluated with 4 hours of normothermic MP, with n = 5 per group. After 4 hours of normothermic MP, the DOSS group demonstrated significantly lower perfusate lactate ( p = 0.023), increased perfusate fibrinogen ( p = 0.005), higher oxygen consumption ( p = 0.018), greater bile production ( p = 0.013), higher bile bicarbonate levels ( p = 0.035) and bile/perfusate sodium ratio ( p = 0.002), and lower hepatic arterial resistance after phenylephrine administration ( p = 0.018). Histological analysis showed lower apoptotic markers in DOSS-preserved livers, with fewer cleaved caspase-3 ( p = 0.039) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL; p = 0.009) positive cells. These findings suggest that DOSS can enhance DCD allograft function during transport, offering potential clinical benefits and contributing to the expansion of the donor pool.

Yutaka Shishido

Kaitlyn M. Tracy

Mark Petrovic

TiOluwanimi Adesanya

Avery K. Fortier

Kimya Raietparvar

Gabriella A. Glomp

Elizabeth Simonds

Timothy R. Harris

Victoria Simon

William D. Tucker

Brandon Petree

Michael Cortelli

Nancy L. Cardwell

Christian Crannell

Jiancong Liang

Alexandria C. Murphy

Blanche L. Fields

Melanie McReynolds

Caitlin T. Demarest

Rei Ukita

Michael Rizzari

Martin Montenovo

Joseph F. Magliocca

Seth J. Karp

M. Ameen Rauf

Ashish S. Shah

Matthew Bacchetta

Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model

新型动态器官保存系统在猪循环死亡后捐献模型中增强肝移植功能

Donor heart machine perfusion enables avoidance of prolonged cold ischemia, however the optimal temperature is yet to be elucidated. Given that maintenance of temperature beyond ambient levels demands significant energy, we sought to determine the suitability of room-temperature perfusion preservation of neonatal/pediatric-sized (5–20 kg) piglet donor hearts. A custom device was fabricated suitable for this purpose, with continuous readout of perfusion pressure, flow rate, temperature, and oxygen saturation. Oxygen delivery was automated to keep saturation above 90%. The perfusate consisted of a 1:1 mix of donor whole blood and modified Krebs–Henseleit solution with albumin. Donor hearts were procured from 5 kg (n = 5), 10 kg (n = 3), and 20 kg (n = 5) piglets, and perfused for 10 hours. Subsequently, 20 kg piglet hearts were transplanted. Hemodynamic stability and echocardiographic measurement of donor heart function were evaluated posttransplant. Perfusate parameters were stable through the perfusion interval. Temperature was consistently 23.8 ± 1.6°C. pH (7.35 ± 0.09) and pO 2 (102 ± 29 mm Hg) were steady throughout. Glucose (5.9 ± 1.8 mmol/L) and lactate (2.4 ± 1.5 mmol/L) were metabolized by the heart over the course of perfusion. Transplanted hearts displayed durable hemodynamics and good biventricular function. We conclude that neonatal and pediatric hearts can be safely perfused for extended periods at subnormothermic conditions using blood-based perfusate.

Mitchell J. Wagner

Guilherme Mainardi Aguiar da Silva

Sanaz Hatami

Mubashir Khan

Lily Lin

Xiuhua Wang

Tara Pidborochynski

Benjamin Adam

Jayan Nagendran

Jennifer Conway

Darren H. Freed

Subnormothermic Machine Perfusion of Neonatal and Small-Sized Pediatric Donor Hearts

新生儿和小儿供体心脏的亚低温机器灌注

A critical factor in thrombus formation during venoarterial extracorporeal membrane oxygenation (VA ECMO) is prothrombotic flow dynamics generated by the drainage cannula’s design. This study aimed to create and evaluate a novel drainage cannula design which optimized blood flow dynamics to reduce thrombus formation. Computational fluid dynamics (CFD) was used to iteratively vary drainage cannula design parameters such as inner wall shape and side hole shape. The final novel design was then placed in an ex vivo blood circulation loop, and compared against a Bio-Medicus cannula (n = 6, each). Clot volume, hemolysis, and other parameters were measured to assess thrombus formation markers. The novel design consisted of a parabolic inner wall profile with closely spaced side holes angled at 30º to align with flow. When tested in the ex vivo loop, the novel design resulted in lower instances (two vs . four) and volumes of clot in the cannula (360.5 ± 254.8 vs . 1258.0 ± 651.7 µl) when compared to the Bio-Medicus cannula. Results from tests assessing hemolysis, platelet activation, and other thrombotic markers revealed a noninferior relationship between the novel and Bio-Medicus designs. Future work will explore the clinical applicability of these findings.

Avishka Wickramarachchi

Saeedreza Zeibi Shirejini

Ashkan Vatani

Akshita Rana

Mehrdad Khamooshi

Michael Šeman

Sam Liao

Edwina Jap

Tuan H. Nguyen

Karen Alt

Aidan Burrell

Vincent A. Pellegrino

David M. Kaye

Christoph E. Hagemeyer

Shaun D. Gregory

Development and Evaluation of a Novel Drainage Cannula for Venoarterial Extracorporeal Membrane Oxygenation

新型静脉-动脉体外膜肺氧合引流插管的开发与评估

The emerging ex vivo machine perfusion (MP) enables the extension of ex situ intervals, potentially expanding the heart transplant (OHT) donor pool. From October 18, 2018, to June 30, 2023, isolated OHT using donation after brain death (DBD) from extended distances (>500 miles) were identified in the United Network for Organ Sharing database, and categorized into cold storage (non-MP, N = 1,212) and MP group (N = 152). The MP utilization rate for DBD hearts from extended distances surged from 0% in 2018 to 27.7% in 2023. Recipient characteristics including listing status were similar except for history of cardiac surgery (non-MP, 32% vs. MP, 41%, p = 0.019). The travel distance was longer in MP group (696 vs. 894 miles, p < 0.001), as was donor organ preservation time (4.42 vs. 6.27 hours, p < 0.001). One-year survival was similar between groups (non-MP, 93.0 ± 0.8% vs. MP, 90.5 ± 2.9%, p = 0.23). In multivariable Cox hazards models, MP was not associated with mortality (hazard ratio, 1.19; p = 0.60). Among MP cohort, survival was comparable between hearts transported between 500-999 miles (N = 112) and those over 1,000 miles (N = 40). The utilization of MP for DBD heart recovery allows for safe DBD recovery from extended distance with comparable survival to cold storage.

Suguru Ohira

Sooyun Caroline Tavolacci

Kenji Okumura

Ameesh Isath

Vasiliki Gregory

Corazon de la Pena

Masashi Kai

Machine Perfusion for Recovery of Brain Death Donor Hearts from Extended Distances

机器灌注用于远距离脑死亡供体心脏的恢复

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is applied for the treatment of cardiogenic shock. Concomitant left ventricular unloading (LVU) with a microaxial flow pump (mAFP) enables myocardial and pulmonary recovery and may overcome some of the limitations of VA-ECMO. The study included 145 cardiogenic shock patients, 89 (61.4%) of whom were treated with VA-ECMO alone (ECMO group), whereas 56 (38.6%) received LVU with a surgically implanted mAFP on top of VA-ECMO (ECMELLA group). After 2:1 propensity score matching, 30 day and 1 year survival was similar between the groups ( p = 0.62 and 0.68, respectively). In the subgroup analysis, patients who received mAFP in the first 2 hours after VA-ECMO implantation had an improved 30 day (hazard ratio [HR]: 0.45 [95% confidence interval {CI}: 0.23–0.88], p = 0.02) and 1 year survival (HR: 0.52 [95% CI: 0.28–0.97], p = 0.04). The rate of limb ischemia, hemorrhage, and renal replacement therapy were comparable between the propensity score-matched cohorts. Early LVU with a surgically implanted mAFP in patients on VA-ECMO improved short-and long-term survival.

Pia Lanmüller

Nils Hinrichs

Gaik Nersesian

Daniel Lewin

Ben O’Brien

Volkmar Falk

Evgenij Potapov

Christoph Starck

Sascha Ott

Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation

在静脉-动脉膜氧合患者中使用手术植入微轴流泵进行左心室卸载

Abbreviation	ASAIO. J.
Journal Impact	3.22
Quartiles(Global)	TRANSPLANTATION(Q2)

ISSN	1058-2916, 1538-943X
h-index	80

Publication Information	Publisher: Lippincott Williams and Wilkins，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1992，Proportion of original research papers: 91.92%，Self Citation Rate:6.50%， Gold OA Rate: 5.77%
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：容易

ASAIO Journal

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Extracorporeal Life Support Organization (ELSO): 2020 Pediatric Respiratory ELSO Guideline

ELSO Interim Guidelines for Venoarterial Extracorporeal Membrane Oxygenation in Adult Cardiac Patients

Venoarterial Extracorporeal Membrane Oxygenation Support for Ventricular Tachycardia Ablation: A Systematic Review

Platelet, Red Cell, and Endothelial Activation and Injury During Extracorporeal Membrane Oxygenation

Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model

Subnormothermic Machine Perfusion of Neonatal and Small-Sized Pediatric Donor Hearts

Development and Evaluation of a Novel Drainage Cannula for Venoarterial Extracorporeal Membrane Oxygenation

Machine Perfusion for Recovery of Brain Death Donor Hearts from Extended Distances

Novel Dynamic Organ Storage System Enhances Liver Graft Function in a Porcine Donation After Circulatory Death Model

Left Ventricular Unloading With Surgically Implanted Microaxial Flow Pump in Patients on Venoarterial Membrane Oxygenation