A Volume-Adjustable Artificial Womb for Extremely Preterm Infants

Transplant International, vol. 37, pp. 12947

Abstract

More than 13 million children are born preterm annually. Prematurity-related mortality accounts for 0.9 million deaths worldwide. The majority of those affected are Extremely Preterm Infants (gestational age less than 28 weeks). Immaturity causes organ failure and specific morbidities like germinal matrix hemorrhage, bronchopulmonary dysplasia, and necrotizing enterocolitis. Artificial womb and placenta technologies address these issues. As a bridge-to-life technology, they provide a liquid environment to allow organ maturation under more physiological conditions. The proposed artificial womb can adapt to fetal growth. Volume adjustment is achieved by removing fluid from the interspace between an inner and outer chamber. Results of the in vitro tests showed a temperature constancy of 36.8°C ± 0.3°C without pressure loss over 7 days. The volume of the inner sac was variable between 3.6 and 7.0 L. We designed a filtration and disinfection system for this particular purpose. This system has proven strong disinfection capabilities, effective filtering of metabolic waste, and the ability to avoid phospholipid washout. The presented artificial womb has sufficient volume variability to adapt to the physiologic growth of an extremely preterm neonate over a 4-week period. We regard this as an important step in the development of this bridge-to-life technology.

Authors 10

1. Jan Heyer corresponding Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

2. Franziska Schubert Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

3. A Seitz Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

4. Yannick Steinle Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

5. Jutta Arens

   University of Twente

   Affiliation as printed

   Engineering Organ Support Technologies Group, Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands

   Engineering Organ Support Technologies Group, Netherlands

6. Thorsten W Orlikowsky Aachen Pediatric Clinic Neonatology Section

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Pediatric Clinic, Neonatology Section, RWTH Aachen University and University Hospital, Aachen, Germany

   Pediatric Clinic, Germany

7. Ulrich Steinseifer Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

8. Thomas Schmitz‐Rode Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

9. Sebastian Victor Jansen Aachen Department of Cardiovascular Engineering Institute of Applied Medical Engineering

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Department of Cardiovascular Engineering, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University and University Hospital, Aachen, Germany

   Department of Cardiovascular Engineering, Germany

10. Mark Schoberer Aachen Pediatric Clinic Neonatology Section

    Universitätsklinikum Aachen · RWTH Aachen University

    Affiliation as printed

    Pediatric Clinic, Neonatology Section, RWTH Aachen University and University Hospital, Aachen, Germany

    Pediatric Clinic, Germany