In this STAR interview, we speak to Jutta Arens of the Faculty of Engineering Technology (ET). STAR is an acronym for (S)ituation, (T)asks, (A)ctions, (R)esults. We have many “star” colleagues at UT with interesting stories to tell. Jutta Arens develops a novel class of combined artificial lung & kidney devices for a better and safer treatment of patients. 
Situation
What is/was the situation (S) of your research/initiative?
Today, we see more and more patients with chronic diseases of the heart, the lungs, and other internal organs, but unfortunately a shortage of donor organs for transplantation worldwide. Additionally, we also see patients with acute, life-threatening diseases of these organs, such as COVID-19. The latter might not need a transplantation, but temporary support of the damaged organ until it recovers. A third group of patients are our smallest and most vulnerable: premature babies who are born with, e.g. immature lungs, who need a lung support that allows their native lungs to mature and take up their work.
For all these patients, artificial organs such as artificial lungs or heart support pumps can provide a solution that can bridge them to transplantation while they are on the waiting list, bridge them to recovery, or provide a destination therapy.
Tasks
What tasks (T) were or are you currently working on?
Many patients in need of artificial lung treatment (also known as ECMO – Extracorporeal Membrane Oxygenation) also develop acute kidney injury caused by disturbed hemodynamics, lung-kidney cross-talk, etc. and/or have a disturbed fluid balance. These patients might need temporary kidney support (dialysis or hemofiltration) on top of the lung support treatment. Currently, this requires a second access to the patient's blood vessels, a second blood pump, blood tubing and the dialyser in addition to the artificial lung device. This increases the risk for the patient and the task load of the caregivers. Therefore, we work on combining the artificial lung with an artificial kidney in a single device to make the treatment easier accessible, less complex, and thus safer for the patients. Here, we work on the design of novel devices for different age groups, membrane development, and production methods.
Actions
What actions (A) are you working on and who are involved?
This technology of an artificial lung with integrated kidney support requires dedicated dialysis fibers that allow the blood to flow on the outside of the membrane fibers instead of the classical use with blood flowing on the inside. We are in the process to develop these fibers in cooperation with the UT spin-off company EMI Twente B.V. on campus. And the entire project is part of the priority program “Towards an implantable lung” financed by the German Research Foundation (DFG, SPP 2014) bringing together experts from RWTH Aachen University & University Hospital, Hannover Medical School, University Hospital Regensburg, and University of Würzburg.
Additionally, we are part of a EU-financed consortium with 10 partners, incl. 2 from industry from 5 different countries, with whom we will make use of the above-mentioned technology as an artificial placenta (ArtPlac) system for premature newborns (www.artplac.eu). For this, we not only need to design the novel lung & kidney support device, but also cannulae that fit into the blood vessels of the umbilical cord and sensor systems to monitor our patients. The biggest challenges with this project are the very small size of the patients we have to fit our devices to (which pushes the physical limits of feasibility), their vulnerability and the need for skin-to-skin contact with the parents, which means our device has to be transported safely with the baby.
Results
What results (R) do you hope to achieve, and how will society (or UT organisation) perceive them?
With the world market leader in ECMO devices, Maquet/Getinge, on board with the ArtPlac project, we hope to develop a novel class of combined artificial lung & kidney devices for a better and safer treatment of our patients. Especially for our smallest patients, we hope to make the transition from premature birth into life less invasive and safer, and by this prevent lifelong disabilities.
In the past years with the COVID-19 pandemic, we were reminded how vulnerable we are to virus-caused diseases that affect our lungs and other inner organs in addition to various life-style caused damages etc. Therefore we regard our work as essential to meet the growing demand of safe treatment options for our lungs, hearts, and kidneys.
Interested in more STAR interviews? Click here to read them.
