Artificial trachea transplant: Tale of two stories.

South Korean-based team is first to successfully transplant 3D bioprinted artificial trachea. The success arises during scrutiny of artificial tracheal implants stemming from the denounced work of Dr. Paolo Macchiarini.

In utero fetal organ transplantation.

Transplantation has generally been focused on end-stage organ disease in adults. Scientists from Japan are now focusing on in utero transplantation in fetuses with congenital anomalies.

Bioartificial liver system approved for clinical trials in China.

Bioartificial organ systems are becoming more attractive options for end-stage organ disease. Currently, end-stage liver disease has several palliative options but relies on transplantation for curative management. A new bioartificial liver has been approved for clinical trials in China and helps support the failed liver via stem cells.

Regional pain relief with focused cooling of peripheral nerves.

Opioids are an effective remedy for pain control, but their detrimental side effects are prompting the development of less systemic and addictive options. A team from Pusan National University has developed an implant capable of precisely desensitizing peripheral nerves with temperature regulation. The device employs microfluidic technology.

New development in brain-computer interface platforms: 1-year results from the SWITCH trial.

Synchron publishes SWITCH trial results demonstrating the safety and efficacy of stentrode™ device. The stentrode™ is an endovascularly implanted brain-computer interface communication device capable of relaying neural activity from the motor cortex of paralyzed patients. The platform has been used to recover speech.

Reliable long-term organ cryopreservation makes donor organ bank a feasible reality.

Long-term donor organ preservation has been sought after since the beginning of transplantation. Static cold storage is the gold standard for organ transport but is limited to short-term preservation because of the inability to maintain subfreezing temperatures without harmful ice cyrstal formation. Recent developments in cryopreservation via vitrification and nanowarming have demonstrated reliable storage and restoration of healthy donor organs without ice crystallization.

The economics of artificial organs.

Spurred by devoted research and institutional financing, organ replacement therapies have progressed monumentally over the last century. Concomitantly, there has been an escalation in healthcare costs. In an aging society where organ replacement therapy utilization is expected to continue to rise, will society need to rethink the economics of end-stage organ dysfunction management?

FDA on the verge of approving human clinical trial for artificial womb.

Premature delivery is responsible for immense mortality and morbidity, partially owing to insufficient development of organs. Current supportive measures, like mechanical ventilation, are necessary to sustain life but have deleterious effects on the underdeveloped organs. A more physiological environment-the artificial womb-has been developed and is on the verge of approval for human clinical trials.

Cardiac Xenotransplantation: Progress in Preclinical Models and Prospects for Clinical Translation.

Survival of pig cardiac xenografts in a non-human primate (NHP) model has improved significantly over the last 4 years with the introduction of costimulation blockade based immunosuppression (IS) and genetically engineered (GE) pig donors. The longest survival of a cardiac xenograft in the heterotopic (HHTx) position was almost 3 years and only rejected when IS was stopped. Recent reports of cardiac xenograft survival in a life-sustaining orthotopic (OHTx) position for 6 months is a significant step forward. Despite these achievements, there are still several barriers to the clinical success of xenotransplantation (XTx). This includes the possible transmission of porcine pathogens with pig donors and continued xenograft growth after XTx. Both these concerns, and issues with additional incompatibilities, have been addressed recently with the genetic modification of pigs. This review discusses the spectrum of issues related to cardiac xenotransplantation, recent progress in preclinical models, and its feasibility for clinical translation.

Post-mortem cellular death may be salvageable with whole body perfusion.

A team of Yale researchers demonstrated cellular and metabolic recovery with whole body perfusion after prolonged warm ischemia. This study reveals an underappreciated potential of cellular recovery and may lead to the expansion of suitable warm ischemic times.

Will electronic skins become a quintessential health tracker for everyday life?

Researchers from MIT have developed a chipless wireless electronic skin capable of detecting health information. They have improved upon the sensitivity, power efficiency, and long-term wearability of previous electronic skins. Continued development in this sector may soon make health tracking via electronic skin ubiquitous with the population.

Individualized human physiology modeled in the first multi-organ chip of engineered human tissue.

A team of researchers succeeded in modeling complex human physiology using the first multi-organ chip of human tissue derived from induced pluripotent stem cells. The platform may help more accurately predict various disease and pharmacologic processes.

First successful porcine to human heart transplantation performed in the United States.

In an 8-h operation, the cardiac surgery team at the University of Maryland Medical Center made history by performing the first porcine-to-human heart transplant without signs of early rejection. Xenotransplantation offers a potential solution to the thousands of patients worldwide who die annually while waiting for donor organs.

Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome (CHILD Study).

Mortality in infants with hypoplastic left heart syndrome (HLHS) is strongly correlated with right ventricle (RV) dysfunction. Cell therapy has demonstrated potential improvements of RV dysfunction in animal models related to HLHS, and neonatal human derived c-kit+ cardiac-derived progenitor cells (CPCs) show superior efficacy when compared to adult human cardiac-derived CPCs (aCPCs). Neonatal CPCs (nCPCs) have yet to be investigated in humans. The CHILD trial (Autologous Cardiac Stem Cell Injection in Patients with Hypoplastic Left Heart Syndrome) is a Phase I/II trial aimed at investigating intramyocardial administration of autologous nCPCs in HLHS infants by assessing the feasibility, safety, and potential efficacy of CPC therapy. Using an open-label, multicenter design, CHILD investigates nCPC safety and feasibility in the first enrollment group (Group A/Phase I). In the second enrollment group, CHILD uses a randomized, double-blinded, multicenter design (Group B/Phase II), to assess nCPC efficacy based on RV functional and structural characteristics. The study plans to enroll 32 patients across 4 institutions: Group A will enroll 10 patients, and Group B will enroll 22 patients. CHILD will provide important insights into the therapeutic potential of nCPCs in patients with HLHS.Clinical Trial Registration https://clinicaltrials.gov/ct2/home NCT03406884, First posted January 23, 2018.

Trends in the utilization and reimbursement of coronary revascularization in the United States Medicare population from 2010 to 2018.

OBJECTIVE: To determine utilization and reimbursement trends of coronary revascularization procedures in the US Medicare population from 2000 to 2018. BACKGROUND: US Medicare population is increasing, and coronary revascularization decreased in the 2000s. METHODS: This is a population-based, cross sectional study of US Medicare beneficiaries from 2010 to 2018. The Centers for Medicare and Medicaid Services' database was queried for revascularization procedures using the coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) current procedural terminology (CPT) codes. Trends in Medicare enrollees, PCIs, CABGs, and physician reimbursements were analyzed. RESULTS: Total utilization and reimbursement decreased for both revascularization procedures. The national CABG and PCI utilization per enrollee has decreased by 40.7% (best fit line: b coefficient, 95% CI; -0.297, -0.358 to -0.235) and 26.4% (best fit line: -0.229, -0.373 to -0.0858), respectively. For CABG, annual Medicare payout per enrollee and physician compensation per procedure has decreased by 49.3% (best fit line: -0.250, -0.315 to -0.185) and 14.5% (best fit line: -11.54, -15.62 to -7.452), respectively, and for PCI, decreased by 53.3% (best fit line: -0.373, -0.560 to -0.186) and 36.6% (best fit line: -34.15, -49.35 to -18.95), respectively. Amongst the states, there was significant variability in procedure utilization, and CABG reimbursement rates but minimal variability in PCI reimbursement rates. CONCLUSION: Even though the US population has aged, revascularization utilization and reimbursement continue to decline. Advancement in medical intervention strategies, particularly non-surgical management, may account for these trends. Further understanding of these trends will allow health systems to tailor resources to the aging population.

Competition brings out the best in people, and this year's KidneyX Summit did not disappoint.

Six teams receive large-sum awards in the first round of the Artificial Kidney competition to further develop concepts that significantly improve upon existing dialysis methods.