Milestones for clinical translation of the artificial placenta. Issue 6 (December 2022)

• Record Type: Journal Article
• Authors: Spencer, Brianna L.; Mychaliska, George B.
• Is Part Of: Seminars in fetal & neonatal medicine. Volume 27:Issue 6(2022)
• Publication Date: 2022-12
• Subjects: Artificial placenta -- Artificial womb -- EXTEND -- EVE -- ECLS -- Prematurity -- ELGANs; Neonatology -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.9201
• DOI: 10.1016/j.siny.2022.101408
• Languages: English
• ISSNs: 1744-165X

Abstract

Abstract: Despite significant advances in the treatment of prematurity, premature birth results in significant mortality and morbidity. In particular, extremely low gestational age newborns (ELGANs) defined as <28 weeks estimated gestational age (EGA) suffer from disproportionate mortality and morbidity. A radical paradigm shift in the treatment of prematurity is to recreate fetal physiology using an extracorporeal VV-ECLS artificial placenta (AP) or an AV-ECLS artificial womb (AW). Over the past 15 years, tremendous advances have been made in the laboratory confirming long-term support and organ protection and ongoing development. The major milestones to clinical application are miniaturization, anticoagulation, clinical risk stratification, specialized critical care protocols, a regulatory path and a strategy and platform to translate technology to the bedside. Currently, several groups are addressing the remaining milestones for clinical translation.