The International journal of artificial organs
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Given the benefit of pulsatile blood flow for perfusion of coronary arteries and end organs, pulsatile ventricular assist devices (VADs) are still widely used as paracorporeal mechanical circulatory support devices in clinical applications. However, poor hemocompatibility limits the service period of the VADs. Most previous improvements on VAD hemocompatibility were conducted by trial-and-error CFD analysis, which does not easily arrive at the best solution. ⋯ The results suggest that the proposed multi-objective optimization method has the potential for application in optimizing pulsatile VAD hemocompatibility, and may also be applied to other blood-wetted devices.
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Patients with severe portopulmonary hypertension (PoPH) responsive to medical therapy may be considered for liver transplantation. We present a case of extracorporeal membrane oxygenation (ECMO) resuscitation for PoPH crisis in a child following liver transplantation (LT), and review the literature on management of this challenging setting. ⋯ ECMO resuscitation and support may be deployed as rescue therapy around the period of liver transplantation. We highlight the importance of patient selection and high risk of complications during ECMO therapy as a bridge to PoPH control.