Successful maintenance of key physiological parameters in preterm lambs treated with ex vivo uterine environment therapy for a period of 1 week

Usuda, Haruo; Watanabe, Shimpei; Miura, Yoshio; Saito, Masatoshi; Musk, Gabrielle C.; Rittenschober-Böhm, Judith; Ikeda, Hideyuki; Sato, Shinichi; Hanita, Takushi; Matsuda, Tadashi; Jobe, Alan H.; Newnham, John P.; Stock, Sarah; Kemp, Matthew W.

doi:10.1016/j.ajog.2017.05.046

Cited by 50 publications

(68 citation statements)

References 53 publications

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“…In previous reports based on our EVE system we demonstrated healthy fetal survival for a period of hours (h), and further extended that to 336 h in a subsequent set of unpublished experiments. [7][8][9][10] Other investigators have reported the successful application of artificial-placenta based therapies for up to h with similar concepts and extracorporeal gas exchange systems. [11][12][13][14] Accordingly, the feasibility of long survival with a pumpless extracorporeal system has been well documented in the experimental literature.…”

Section: A N U S C R I P Tmentioning

confidence: 99%

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Successful use of an artificial placenta to support extremely preterm ovine fetuses at the border of viability

Usuda

Watanabe

Saito

et al. 2019

American Journal of Obstetrics and Gynecology

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126

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Section: A N U S C R I P Tmentioning

confidence: 99%

“…The ewe's abdomen was clipped to expose the skin and thoroughly prepared for surgery as described previously. 7,9,10,37 Ewes in both the EVE and the control groups were euthanized with an intravenous bolus of pentobarbitone (160 mg/kg).…”

Section: Experimental Protocolmentioning

confidence: 99%

Successful use of an artificial placenta to support extremely preterm ovine fetuses at the border of viability

Usuda

Watanabe

Saito

et al. 2019

American Journal of Obstetrics and Gynecology

Self Cite

126

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“…With this in mind, researchers are seeking an alternative physiological approach to sustaining underdeveloped human beings by better mimicking the uterine environment to effectively prolong gestation. i 16 This encompasses a support system closer to an AW, facilitating continuing development as if the neonate had never been born , as opposed to infant incubators assisting preterms with bodily functions they cannot perform adequately for themselves.…”

Section: Artificial Wombs—where Are We?mentioning

confidence: 99%

Artificial womb technology and the frontiers of human reproduction: conceptual differences and potential implications

Romanis

2018

J Med Ethics

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In 2017, a Philadelphia research team revealed the closest thing to an artificial womb (AW) the world had ever seen. The ‘biobag’, if as successful as early animal testing suggests, will change the face of neonatal intensive care. At present, premature neonates born earlier than 22 weeks have no hope of survival. For some time, there have been no significant improvements in mortality rates or incidences of long-term complications for preterms at the viability threshold. Artificial womb technology (AWT), that might change these odds, is eagerly anticipated for clinical application. We need to understand whether AWT is an extension of current intensive care or something entirely new. This question is central to determining when and how the biobag should be used on human subjects. This paper examines the science behind AWT and advances two principal claims. First, AWT is conceptually different from conventional intensive care. Identifying why AWT should be understood as distinct demonstrates how it raises different ethico-legal questions. Second, these questions should be formulated without the ‘human being growing in the AW’ being described with inherently value laden terminology. The ‘human being in an AW’ is neither a fetus nor a baby, and the ethical tethers associated with these terms could perpetuate misunderstanding and confusion. Thus, the term ‘gestateling’ should be adopted to refer to this new product of human reproduction: a developing human being gestating ex utero. While this paper does not attempt to solve all the ethical problems associated with AWT, it makes important clarifications that will enable better formulation of relevant ethical questions for future exploration.

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“…A preterm lamb model of an 'artificial placenta,' or ex vivo uterine environment (EVE) therapy, has recently been developed. 7,8,11,17 This model is an artificial version of extracorporeal support of the fetus, which is ordinarily provided by the placenta in utero. 11 Priming of the extracorporeal circuit in these models requires whole blood, and fresh maternal blood is used initially.…”

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confidence: 99%

Crossmatching Maternal and Fetal Blood in Sheep

et al. 2018

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We investigated the incidence of ex vivo incompatibility between ovine maternal RBC and fetal plasma. Time-mated singleton pregnant ewes (n = 8) underwent cesarean delivery of the fetus; at the time of delivery, paired maternal and fetal blood samples were collected and subsequently separated for storage as packed RBC and fresh frozen plasma. Gel column crossmatching was performed 3 to 4 wk later. All fetus-dam crossmatches were considered major crossmatches, combining fetal (recipient) plasma with dam (donor) RBC. The plasma of 8 fetuses was cross-matched with RBC from 5 dams; all autologous controls were negative, and all but one crossmatch (1 of 40, 2.5%) were considered compatible. In addition, the plasma of 3 dams was crossmatched with RBC from 5 dams; all autologous controls were negative; however, significant incompatibility was noted. In total, 4 of 13 (30.8%) dam-dam crossmatches were considered incompatible. The results of this initial study suggest that when a single animal receives multiple blood-product transfusions, the risk of an immunologic transfusion reaction can be reduced by ensuring that the blood products are obtained from a single donor, performing a crossmatch prior to transfusion, and the use of synthetic products to increase the oxygen carrying capacity of fetal blood.

show abstract

Successful maintenance of key physiological parameters in preterm lambs treated with ex vivo uterine environment therapy for a period of 1 week

Cited by 50 publications

References 53 publications

Successful use of an artificial placenta to support extremely preterm ovine fetuses at the border of viability

Successful use of an artificial placenta to support extremely preterm ovine fetuses at the border of viability

Artificial womb technology and the frontiers of human reproduction: conceptual differences and potential implications

Crossmatching Maternal and Fetal Blood in Sheep

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