Melina Piazza
Pronouns: she/her
Research Mentor(s): Alvaro Rojas-Peña
Research Mentor School/College/Department: Department of Surgery-Transplantation / Medicine
Program: UROPF
Session: Session 1 (9:00am – 9:50am)
Authors: Melina Piazza, Alvaro Rojas-Pena
Abstract
Severe prematurity is associated with high mortality, morbidity, and medical cost. Current therapies include mechanical ventilation (MV) and Extracorporeal life support (ECLS). MV is associated with ventilator-induced lung injury and subsequent bronchopulmonary dysplasia. ECLS is limited to >2 kg patients and associated with hemorrhage, thrombotic events, multi-organ dysfunction, and infection. As a result, an alternative therapy, the artificial placenta (AP) has been proposed, a novel miniaturized ECLS system. This work reviews and describes the success, challenges, and limitations of the AP. A literature search was conducted through PubMed and Ovid databases, using “artificial placenta†and “animal model†as keywords without publication date limitation. Twenty-eight (28) papers were identified, those in which AP support was <24 hours were excluded. Eight (8) publications were reviewed and analyzed. Species of animal models were ovine (7/8) and porcine (1/8). The length of successful support of premature animals was a range of 1-9 days, specifically: <3 days (4/8), 1/8 for 3-7 days, and 3/8 for =7 days. Measured biological variables varied in each study, 6/8 had normal hemodynamics (heart-rate/arterial-pressure/gas exchange), 4/8 determined no intracranial hemorrhage, 2/8 observed less alveolar hemorrhage than MV, and 1/8 normal alveolar branching. Overall, 7/8 favored AP over MV. Despite success, 5/8 studies reported vascular access injury, 4/8 cardiac complications, 3/8 infection or organ failure, and 1/8 minor complications. Data suggests that the AP can support premature animals and allows for multi-organ development. Prior to clinical translation challenges with AP vascular access, anticoagulation, and infection need to be resolved.
