Research overview
Ex vivo uterine environment therapy is an experimental life support platform designed to reduce the risk of morbidity and mortality for extremely preterm infants born at the border of viability (21–24 weeks’ gestation).
To spare the functionally immature lung, this platform performs gas exchange via a membranous oxygenator connected to the umbilical vessels, and the fetus is submerged in a protective bath of artificial amniotic fluid.
We and others have demonstrated the feasibility of extended survival with ex vivo uterine environment therapy in late preterm fetuses, however, at the time of this research there was no evidence to show that the use of such a platform can support extremely preterm fetuses, the eventual translational target for therapy of this nature.
Objective
The objective of the study was to use our ex vivo uterine environment therapy platform to support the healthy maintenance of 600–700 g/95 days gestational age (equivalent to 24 weeks of human gestation) sheep fetuses.
Primary outcome measures were as follows:
- maintenance of key physiological variables
- absence of infection
- absence of brain injury, and
- growth and cardiovascular function patterns matching that of noninstrumented, age-matched in utero controls.
Project outcome
For several decades, there has been little improvement in outcomes of extremely preterm infants born at the border of viability. In the study, we report the use of artificial placenta technology to support, for the first time, extremely preterm ovine fetuses (equivalent to 24 weeks of human gestation) in a stable, growth-normal state for 120 hours. With additional refinement, the data generated by this study may inform a treatment option to improve outcomes for extremely preterm infants.
Project researchers
Dr Haruo Usuda
Professor Matt Kemp
Dr Sean Carter
Ms Erin Fee
Partners
The University of Western Australia
Tohoku University Hospital, Japan
Nipro Corporation
Funders
Channel 7 Telethon Trust
The Department of Health, Government of Western Australia
Nipro Corporation
Women and Infants Research Foundation
National Health and Medical Research Council.
Project timeline
Completed 2019
Publication
Related publications
USUDA H, SAITO M, IKEDA H, et al. Assessment of synthetic red cell therapy for
extremely preterm ovine fetuses maintained on an artificial placenta lifes upport
platform. Artificial Organs 2021.
USUDA H, FEE EL, TAKAHASHI T, TAKAHASHI Y, CARTER S, NEWNHAM JP, KEMP MW. The artificial placenta: SCI-FI or reality? Revista Médica Clínica Las Condes 2021;32:699-706.
USUDA H, WATANABE S, SAITO M, et al. Successful use of an artificial placenta–based life support system to treat extremely preterm ovine fetuses compromised by intrauterine inflammation. American Journal of Obstetrics and Gynecology 2020;223:755. e1-55. e20.
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