# Reperfused human umbilical cords as an ex vivo model for ECMO cannulation in artificial placenta technology

## TL;DR

Researchers developed a human umbilical cord model to train and test ECMO cannulation techniques for artificial placenta technology.

## Contribution

A novel ex vivo model using reperfused human umbilical cords for training and testing ECMO cannulation procedures.

## Key findings

- Terminal cannulation succeeded in 43 out of 67 umbilical cord specimens.
- A physiological flow of 71.2 mL/min was achieved in the validation study.
- ECMO cannulation of all three vessels was successful in five cases.

## Abstract

Establishing an extracorporeal circuit for artificial placenta technologies requires the cannulation of the umbilical vessels with large-bore cannulas. So far, this procedure could only be performed in large-animal models. We present the methodology and a novel test setup for reperfusion of human umbilical cords to develop and train cannulation procedures.

67 umbilical cords and placentas were harvested during cesarian sections, 15 cm umbilical cord specimen and fetal blood were used for these experiments. All three umbilical vessels were flushed, terminal cannulated, and connected to a circuit. We performed systematic validation tests on reperfusion of 15 umbilical cord specimens, followed by an ECMO cannulation of all three reperfused vessels.

The terminal cannulation succeeded in 43 of 67 cases. 15 of these were included in the validation study. A physiological flow of 71.2 mL/min ±3.9 mL/min (mean ± SD) could be established. ECMO Cannulation of at least one artery and one vein succeeded in 9 of 15 cases, and cannulation of all three vessels in five cases.

Reperfusion of human umbilical cord specimens with fetal blood can provide a biosimilar model for the development, testing, and training of umbilical vessel cannulation with large-bore cannulas.

Diagram illustrating three stages of a medical process. The left panel shows cannulation at both ends with a diagram of an umbilical cord and a photo of an introducer sheath. The middle panel depicts reperfusion with a schematic of fetal loops and a photo of a reperfused umbilical cord. The right panel shows ECMO cannulation with a diagram of placental loops and an image of ECMO cannulae in use. Each section includes labels and schematic elements representing medical connections.