Invited Editorial

Outcomes of the International PediatricPerfusion Symposiums

Congenital heart defects are the number one birthdefect in the Western Hemisphere (1).Although mor-tality rates have significantly declined during the pastdecade, vital organ injury is common during acuteand chronic cardiac and/or pulmonary support, inparticular for neonates and infants (2,3). It is impera-tive to exchange novel ideas among clinicians, scien-tists, and engineers to improve the outcomes of thesefragile patients (4). Based on the recent survey, mostclinicians learn new techniques and devices byattending international conferences, symposiums,and workshops (5–8).

Since 2010, a team from MAQUET Cardiopulmo-nary AG (Rastatt, Germany) has organized threeconsecutive international symposiums solely dedi-cated to neonates, infants, and pediatric patients withacute and chronic cardiopulmonary support. Themain focus of the International Pediatric PerfusionSymposium (IPPS) was to invite international schol-ars and leading investigators around the globe todiscuss the latest research results and evaluations ofnew devices and perfusion strategies.The objective ofthis editorial is to share the outcomes of these threeconsecutive international symposiums with thepublic.

FIRST SYMPOSIUM IN 2010

The first International Pediatric Perfusion Sympo-sium was held at the Sheraton Hotel,Antalya,Turkey,October 29–30, 2010. One hundred and thirty invitedparticipants from 15 countries attended the 2-dayscientific symposium. Seventeen leading investigatorspresented over 20 presentations to cover the latestdevelopments in this underserved field (Table 1).Main topics were the following: (i) fluid physics inpediatric perfusion including shear stress, pressuredrop in fluid motion, hemolysis, microfluidic aspectsof pediatric devices, and evaluation of new neonataloxygenators with integrated arterial filters; (ii) extra-

corporeal and mechanical support including TorontoSickKids Rescue ECLS, Berlin Heart Excor forpediatric patients, first use of the QUADROX-iDPediatric oxygenator for extracorporeal life supportsystems (ECLS), and simulation of neonatal andpediatric ECLS including hands-on training; and(iii) strategies of minimizing injury during cardio-pulmonary bypass procedures including vacuum-assisted venous drainage, miniaturized bypass circuitson blood transfusion, temperature management,optimal pH during hypothermic cardiopulmonarybypass (CPB), brain protection using multimodalitymonitoring techniques, cerebral oximetry, and feasi-bility of serological testing of multiple biomarkers forvital organ injury during and after CPB procedures.At the end of scientific sessions on the second day ofthe event, participants also had an opportunity tovisit the MAQUET manufacturing facilities inAntalya, Turkey.

SECOND SYMPOSIUM IN 2011

The second IPPS was held in Dubai, United ArabEmirates, October 23–25, 2011. Twenty-two speakersalong with over 160 invited participants from 24countries participated at the second event (Table 2,Fig. 1). The second event covered all aspects of pedi-atric cardiopulmonary bypass and extracorporeal lifesupport systems. The special topic was the introduc-tion of the novel pediatric ventricular assist device(VAD) entitled ROTASSIST Set 2.8 including asneak preview of the new pediatric VAD pump byMAQUET.This was the first scientific presentation ofthis novel pediatric VAD. Participants of the secondsymposium also enjoyed fruitful peer-to-peer discus-sions during the social events such as visiting the BurjKhalifa, the highest building in the world.

THIRD SYMPOSIUM IN 2012

The third IPPS was held at the Sheraton Hotel,Toronto, Canada, October 5–7, 2012. Nineteeninvited lecturers along with 130 participants from 19doi:10.1111/aor.12043

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© 2013, Copyright the AuthorsArtificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Artificial Organs 2013, 37(2):116–120

countries attended (Table 3, Fig. 2). Colin Greenopened the scientific sessions with a great lecture onthe history of pediatric cardiac surgery and extracor-poreal life support systems. In addition to coveringseveral extracorporeal life support systems includinganticoagulation monitoring protocols, pulsatileversus nonpulsatile perfusion in pediatric patientsduring CPB along with microemboli detection andclassification systems and performance of oxygenatordesign with integrated arterial filters were alsocovered by invited lecturers (Fig. 2). The third eventincluded several parallel wet-labs on ROTASSIST

2.8: set-up, priming, and safety features in smallgroups along with simulation workshops (Fig. 3).Once again, participants discussed the content of theday’s sessions during the social events includingdinners during a cruise and on top of the famous CNTower in downtown Toronto (Fig. 4).

FINANCIAL SUPPORT

MAQUET Cardiopulmonary AG (Rastatt, Ger-many) sponsored all three symposiums financially.Hotel accommodation and travel expenses of all

TABLE 1. Faculty of the first International Pediatric Perfusion Symposium in 2010

No Speaker Institution

1 Mehmet Agirbasli Marmara University Medical School, Istanbul, Turkey2 Ingela Andersson Lund University Hospital, Sweden3 Tim Antonius UMC St. Radboud Nijmegen, The Netherlands4 Lisa Carson Glenfield Hospital, Leicester, UK5 Sebastian Dahlbacka Oulu University Hospital, Finland6 Yves Durandy Institute Hospital Jacques Cartier, Massy, France7 Johannes Gehron University Hospital Gieben, Germany8 Colleen Gruenwald The Hospital for Sick Children, Toronto, Canada9 Judith Hall Royal Brompton Hospital, London, UK

10 Barry Kussman Children’s Hospital, Boston, MA, USA11 Roelien Kok-van Leeuwen University Hospital of Utrecht, The Netherlands12 Dominique Liotard Hôpital Cardio-thoracique et Vasculaire, Lyon, France13 Jürgen Markmann Technical University of Hamburg-Harburg, Germany14 Eugen Sandica HDZ Bad Oeynhausen, Germany15 Allison Bednarski Spiwak Ohio State University Medical Center, OH, USA16 Ralf Thölke MAQUET Cardiopulmonary AG, Rastatt, Germany17 Akif Ündar Penn State Hershey Medical Center, PA, USA

TABLE 2. Faculty of the second International Pediatric Perfusion Symposium in 2011

No Speaker Institution

1 Atif Akcevin American Hospital, Istanbul, Turkey2 Jutta Arens Institut für Angewandte Medizintechnik, Helmholtz-Institut der RWTH Aachen und

Universitätsklinikum Aachen, Germany3 Mirela Bojan Necker-Enfants Malades Hospital, Paris, France4 Christos Calaritis Montréal Children’s Hospital, Canada5 Yves Durandy Institute Hospital Jacques Cartier, Massy, France6 Steffen Hien Children’s Hospital University of Mannheim, Germany7 Tim Jackson Royal Brompton Hospital in London, UK8 Jean Kharsa Hotel-Dieu de France Hospital, Beirut, Lebanon9 Thomas Markmann MAQUET Cardiopulmonary AG, Rastatt, Germany

10 Maha Nassar Dar EI-Fouad Hospital, Cairo, Egypt11 Vince Olshove The Heart Center at Nationwide Children’s Hospital in Columbus, OH, USA12 Claudia Otto MAQUET Cardiopulmonary AG, Rastatt, Germany13 Valeria Perez Skåne University hospital, Lund, Sweden14 Tom Preston The Heart Center at Nationwide Children’s Hospital in Columbus, OH, USA15 Luk Rondelez Children’s Hospital HUDERF in Brussels, Belgium16 Eugen Sandica HDZ Bad Oeynhausen, Germany17 Ulrich Schweigmann University Hospital, Innsbruck, Austria18 Stuart Sheppard Southampton University Hospital, UK19 Flip De Somer University Ziekenhuis, Gent, Belgium20 Ulrich Steinseifer Institut für Angewandte Medizintechnik, Helmholtz-Institut der RWTH Aachen und

Universitätsklinikum Aachen, Germany21 Akif Ündar Penn State Hershey Medical Center, PA, USA22 Eberhard Vestweber-Wilme Sheikh Khalifa Medical City, Abu Dhabi, U.A.E.

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invited lecturers as well as invited participants were allpaid by the MAQUET headquarters and its localSales and Service Units.

SUMMARY

During the past 3 years, over 60 invited lecturersalong with over 400 participants from 25 counties all

around the globe participated and shared theirknowledge in this underserved area of research. Thelatest development of novel techniques and deviceswere shared. Despite these symposiums sponsored bya company, invited investigators had 100% freedomfrom commercial bias. Most of the presentationswere not even involved with the sponsoring of thecompany’s products.

FIG. 1. Participants of the second Inter-national Pediatric Perfusion Symposiumin 2011.

TABLE 3. Faculty of the third International Pediatric Perfusion Symposium in 2012

No Speaker Institution

1 Tim Antonius UMC St. Radboud, Nijmegen, The Netherlands2 Jutta Arens Institut für Angewandte Medizintechnik, Helmholtz-Institut der RWTH Aachen und

Universitätsklinikum Aachen, Germany3 Christos Calaritis Montréal Children’s Hospital, Canada4 Neil Casey Children’s Hospital of British Columbia, Vancouver BC, Canada5 Yves Durandy Institute Hospital Jacques Cartier, Massy, France6 Ken Gardiner Queen Elizabeth II Hospital, Halifax, Canada7 Johannes Gehron University Hospital, Gieben, Germany8 Colin Green MAQUET Cardiopulmonary AG, Rastatt, Germany9 Colleen Gruenwald The Hospital for Sick Children, Toronto, Canada

10 Carole Hamilton Vogtareuth Schoen Clinic, Germany11 Steffen Hien Children’s Hospital University of Mannheim, Germany12 Gerhard Hilla MAQUET Cardiopulmonary AG, Rastatt, Germany13 Scott Lawson Children’s Hospital Colorado, Aurora, CO, USA14 Victoria Molyneux Great Ormond Street Hospital, London, UK15 Marco Monnig MAQUET Cardiopulmonary AG, Rastatt, Germany16 Maha Nassar Dar EI-Fouad Hospital, Cairo, Egypt17 Vince Olshove Cincinnati Children’s Hospital, OH, USA18 Claudia Otto MAQUET Cardiopulmonary AG, Rastatt, Germany19 Jeff Riley Mayo Clinic, Rochester, MN, USA20 Tilmann Schwab MAQUET Cardiopulmonary AG, Rastatt, Germany21 Filip de Somer Universitair Ziekenhuis Gent, Belgium22 Marco Stehouwer St. Antonius Hospital Nieuwegein, The Netherlands23 Akif Ündar Penn State Hershey Medical Center, PA, USA

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Acknowledgments: Special thanks go to Ms.Yvonne Steinhilber and her organization team ofMAQUET Cardiopulmonary AG, Rastatt, Germanyfor organizing the symposiums.

Dr. Ündar’s personal note: This editorial clearlychallenges the common myth about the industry’scontributions to the development of new productsbecause of the small market size of pediatric cardiacpatients (4). The fact is that several for profit compa-nies such as MAQUET Cardiovascular, SORINGroup, and Terumo Cardiovascular deliver newproducts for acute and chronic use for pediatriccardiac patients year after year. In addition, compa-nies like MAQUET and SORIN have started orga-nizing annual international events solely dedicatedto pediatric patients with high scientific standards.Therefore, my personal thanks go to the industry thatcontributed significantly to this underserved popula-tion and clearly made a huge impact on the treatmentof these fragile patients regardless of the profitmargin.

*Thomas Markmann, MBA and†Akif Ündar, PhD

*MAQUET Cardiopulmonary AGKehler Straße 3176437 Rastatt, Germany

†Penn State Hershey Pediatric CardiovascularResearch Center, Department of Pediatrics,

Surgery and BioengineeringPenn State Hershey College of Medicine,Penn State Hershey Children’s Hospital

Hershey, PA, USAE-mail: thomas.markmann@maquet.com

FIG. 2. Participants of the third International Pediatric PerfusionSymposium in 2012.

FIG. 3. Wet-labs in ROTASSIST 2.8:Therapy Application Manager GerhardHilla (3rd from right) explains set-up,priming and safety features in smallgroups at the third symposium.

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3. Gilboa SM, Salemi JL, Nembhard WN, Fixler DE, Correa A.Mortality resulting from congenital heart disease among chil-dren and adults in the United States, 1999 to 2006. Circulation2010;122:2254–63.

4. Ündar A. Facts and myths surrounding pediatric mechanicalcardiovascular circulatory support research: a personal perspec-tive. Artif Organs 2012;36:467–9.

5. Reed-Thurston D, Qiu F, Ündar A, Kopenhaver-Haidet K,Shenberger J. Pediatric and neonatal extracorporeal lifesupport technology component utilization: are U.S. cliniciansimplementing new technology? Artif Organs 2012;36:607–15.

6. Ündar A, Wang S, Krawiec C. Impact of a unique internationalconference on pediatric mechanical circulatory support andpediatric cardiopulmonary perfusion research [Invited edito-rial]. Artif Organs 2012;36:943–50.

7. Ündar A, Alkan-Bozkaya T, Palanzo D, et al. Istanbul sym-posium on neonatal and pediatric cardiopulmonary bypassprocedures. [Guest Editorial]. Artif Organs 2012;36:463–6.

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FIG. 4. Dinner on top of the famous CNTower in downtown Toronto.

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