AUTHOR=Heyer Jan , Schubert Franziska , Seitz Alexander L. , Steinle Yannick , Arens Jutta , Orlikowsky Thorsten , Steinseifer Ulrich , Schmitz-Rode Thomas , Jansen Sebastian V. , Schoberer Mark 

TITLE=A Volume-Adjustable Artificial Womb for Extremely Preterm Infants

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2024

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.12947

DOI=10.3389/ti.2024.12947

ISSN=1432-2277

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