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Arti Ficial Organ Engineering
Arti Ficial Organ Engineering
123
Maria Cristina Annesini Vincenzo Piemonte
Department of Chemical Engineering Faculty of Engineering
Materials and Environment University “Campus Bio-medico” of Rome
University “La Sapienza” of Rome Rome
Rome Italy
Italy
Luca Turchetti
Luigi Marrelli ENEA- Italian National Agency for New
Faculty of Engineering Technologies, Energy and Sustainable
University “Campus Bio-medico” of Rome Economic Development
Rome Rome
Italy Italy
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The information presented in the book is addressed to engineers and is not intended to be directly used to
take any medical decision.
The history of medicine has always been characterized by the attempt to treat a
wide range of diseases, some very serious and with high mortality, and others
debilitating and detrimental for the quality of life of patients. With the increase of
life expectancy, organ failure has become quite common, making the problem of
degeneration of some body parts (organs, joints etc) increasingly critical. Therefore,
the possibility of replacing these parts, represents an interesting opportunity for
increasing life duration and improving its quality.
Substitution of a part of the human body can be achieved by transplantation from
a human or animal donor. Tissues for transplantation can be obtained from the
recipient’s own body (autotransplantation). Tissues or organs can be taken from a
different living or dead compatible human donor (allotransplantation) or from an
animal (xenotransplantation). Unfortunately, while the population of patients
requiring organs continues to increase, the lack of an adequate number of donors,
along with biological and ethical problems connected with allotransplantation and
xenotransplantation, makes organ transplantation still inadequate and the number of
patients on the waiting lists is growing rapidly. A possible alternative to trans-
plantation consists in the use of artificial and bio-artificial organs. The availability
of devices able to substitute, or at least support, damaged vital functions can allow
the patient to be kept alive a long time or, at least, until either a transplantation is
possible or the physiological activity of the native organ is restored. Furthermore,
artificial organs play a key role in enhancing a patient’s quality of life. However, the
current state of development in the fields of biotechnology and bioengineering does
not allow all organs and tissues to be available.
At present, several extracorporeal artificial assist devices are available and in
use, such as the artificial kidney, whereas only few implantable devices are
approved for clinical use. In the last decades, biomedical engineering has made
great strides in this field with the support of nanotechnology, microelectronics, and
biology and with the significant contribution of the fundamentals of chemical
engineering such as thermodynamics, kinetics, and transport phenomena; therefore,
we can imagine that in the future, the number of miniature artificial organs for
permanent implantation will increase. A comprehensive definition considers
v
vi Introduction
1
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Artificial vital organs and medical bionics market (artificial heart, kidney, liver, pancreas and
lungs, ear bionics, vision bionics, exoskeletons, bionic limbs, brain bionics and cardiac bionics)—
Global Industry analysis, size, share, growth, trends and forecast, 2012–2018.
Introduction vii
In substituting a natural joint by an artificial one, two mobile parts touching each
other must slide with a low friction coefficient and negligible tear effects. Suitable
biomaterials must not involve the release of small debris with harmful effects since,
besides wear effects, they activate the reaction of the immune system, which is often
coupled with the release of enzymes that destroy the adjoining tissue. An additional
problem connected with the use of biomaterials is the possible formation of bio-
films. These are aggregates of bacteria which stick irreversibly to surfaces making
multilayer settlements incorporated in a porous matrix that shelters the microor-
ganisms from the attack of antibiotics. This problem can appear in catheters, in
contact lenses, and, with serious effects, in heart valves. The formation of biofilms
depends on the physical and chemical properties of the support surface, especially
on its roughness and porosity, and on material hydrophobicity and chemical com-
position. Several groups of scientists and bioengineers are investigating solutions to
prevent the formation of biofilms through specific coatings and surface treatments.
Today, with the increasing chemical and biological knowledge, the point of view on
the features of biomaterials is changing. For example, in the past, the greatest
chemical and biological inactivity was required for a biomaterial, while now several
very reactive materials are proving to be more suitable for some biomedical
applications. Some materials, for example, form chemical bonds with the sur-
rounding tissue, increasing the stability of prostheses. Other materials degrade and
can be adsorbed onto the tissue when they are no longer necessary.
To conclude, it is very important to highlight that a proper design and operation
of artificial and bio-artificial organs require a deep knowledge of fundamentals of
chemical thermodynamics, transport phenomena, and chemical kinetics, besides
anatomy and physiology. Most of the methods used in blood detoxification are
based on physicochemical operations aimed at removing, in a short time, clinically
important amounts of some substances without appreciable risk for the patient.
Such separation operations are usually performed by selective membranes perme-
able to the toxic substances to be removed and impermeable to the essential
compounds. Understanding of mass transfer across these membranes is therefore
the basis for the design of a hemodialyzer. In hemoperfusion, toxic substances are
removed by adsorption on solid adsorbents and solid–liquid phase equilibrium is
involved. Furthermore, a rheology analysis is usually required in order to avoid
blood cell damage. Likewise, the use of animal cells in bio-artificial organs requires
the knowledge of the fundamentals of bioreactors, often coupled with mass and heat
transfer processes.
The book is divided in two parts: The first one provides a presentation of the
physical fundamentals involved in the technology of artificial and bio-artificial
organs; the second one is devoted to the monographic presentation of the most
important organ support and replacement devices based on mass transfer opera-
tions. More specifically, in the first part, mass transport phenomena are firstly
discussed, from both a local and macroscopic point of view; separation processes
widely used in artificial organs, i.e., separation based on transport through selective
membranes and adsorption, are then presented; finally, the fundamentals of
bioreactor engineering are covered, focusing on the interaction between bioreaction
Introduction ix
kinetics and transport phenomena. The three chapters of the second part are devoted
to devices for blood oxygenation, renal replacement therapy, and liver support. For
each device, a survey of commonly used solutions and the most promising
developments is presented. Mathematical models to assess the performance are
reported as fundamental tools for the quantitative description of clinical devices;
nevertheless, the models proposed are kept simple to keep the focus on the essential
features of each process.
Contents
Part I Fundamentals
1 Diffusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.2 A Rigorous Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
1.3 Diffusivity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 Local Analysis of Mass Transport Phenomena
and Evaluation of the Concentration Profiles . . . . . . . . . . . . . . . 8
1.5 Diffusion Characteristic Time . . . . . . . . . . . . . . . . . . . . . . . . . 10
1.6 Diffusion and Chemical Reaction . . . . . . . . . . . . . . . . . . . . . . . 11
1.6.1 Diffusion and Reaction in Series . . . . . . . . . . . . . . . . . 12
1.6.2 Diffusion and Reaction in Parallel . . . . . . . . . . . . . . . . 14
1.6.3 Oxygen Transport to Tissue . . . . . . . . . . . . . . . . . . . . 15
1.7 Diffusion and Convection . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
2 Mass Transfer Coefficient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
2.2 Definition of Mass Transport Coefficients . . . . . . . . . . . . . . . . . 24
2.3 Evaluation of Mass Transport Coefficient . . . . . . . . . . . . . . . . . 25
2.4 Mass Transfer Between Two Phases. . . . . . . . . . . . . . . . . . . . . 27
3 Membrane Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
3.2 Phenomenological Aspects and Definitions . . . . . . . . . . . . . . . . 34
3.2.1 Membrane Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3.2.2 Membrane Separation Processes. . . . . . . . . . . . . . . . . . 35
3.2.3 Flow Patterns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
3.2.4 Membrane Modules . . . . . . . . . . . . . . . . . . . . . . . . . . 38
3.2.5 Osmosis, Osmotic Pressure,
and Reverse Osmosis . . . . . . . . . ................ 39
xi
xii Contents
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255