The first European project to develop artificial placentas for extremely premature babies already has the results of its first phase. Researchers from the Clínic and Sant Joan de Déu hospitals have managed to keep a sheep fetus alive for 12 days in a highly complex extracorporeal system that simulates the natural placenta. The experts believe that the result will open the door to having a prototype ready for clinical trials within three years, which will guarantee survival of “three to four weeks” in the artificial placenta.
The test aims to reproduce and prolong the physiological conditions of the mother’s uterus. At six months, the fetus’s lungs, intestines, and brain are underdeveloped and unready to function properly outside of the natural placenta. “An extremely premature baby is actually a fetus that has to survive in a very unnatural environment,” the experts compare. The aim of the artificial placenta is to create exactly the best possible environment. Around 25,000 extremely preterm babies are born in Europe every year.
The complexity of the process is manifold. First, the difficulty of ensuring the transition of the fetus from the maternal placenta to the artificial placenta: the umbilical cord, which ensures the exchange of nutrients and oxygen between the embryo and the placenta, irreversibly closes with a two-degree drop in temperature because he understands that the baby already outside is. “We have to outsmart nature,” admits project manager Eduard Gratacós. The team has ensured that all of the transitions made over the past year have been successful.
The first prototype developed includes a protected environment consisting of a translucent container made of biocompatible material, connected to an amniotic fluid circulation system that allows the fetus to be kept in a fluid environment, isolated from external stimuli but accessible for ultrasound examinations This allows continuous monitoring of the fetus.
The system includes an extracorporeal circulation system consisting of an oxygenating membrane and a system of parts designed to facilitate blood circulation and its oxygenation, simulating what occurs naturally in intrauterine life. “We created an environment with a liquid that is exactly the same as that which surrounds it in the natural placenta, because every difference is clearly noticeable,” says Gratacós.
The project worked with around 50 fetal sheep samples as they are similar to humans in size, lungs and cardiovascular characteristics. Of these, three specimens survived 12 days and a few more (the exact number was not given) between nine and 10 days.
After this first phase, which started in 2020 and was funded by the La Caixa Foundation with 3.35 million euros, there follows a second (2023-2025) with another 4.3 million euros, in which the survival time is attempted four weeks and turn the whole system upside down “extreme” security level and develop the bioethical framework. “In the future, we don’t know when, there will be artificial placentas,” defends Gratacós.
“Hospitals need to engage parents and other relevant groups in the community to create robust and comprehensive guidelines for their use,” says Kelly Werner, associate professor of pediatrics in Columbia University’s Department of Neonatology, in a statement. New York (USA) , in statements to Science Media Center Spain. The pediatrician requires specific protocols for the use of the artificial placenta and in any case insists on ensuring natural births. “While this is an encouraging development, the artificial placenta is not intended to replace the natural placenta. In other words, despite these advances, we must do everything we can to support maternal health and reduce the risk factors that lead to preterm birth.”
Other similar studies are currently underway in the USA, Japan and Australia. A similar artificial placenta model is being developed at the University of Michigan (USA), while uterus models are being developed at the University of Pennsylvania (USA), the University of Tohuku (Japan) and the University of Western Australia. artificially. According to the researchers, only the Philadelphia, Pennsylvania project improves their results. “They had a maximum of 28 days. The rest is between seven and ten days. “The Barcelona project is very solid,” emphasizes the project leader.
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