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New Heart Adopts Cow Parts
人工心臟採用牛體組織
By Anne Eisenberg
Scientists have long searched for a durable artificial heart that can work as efficiently as the one supplied by nature. Now, an artificial heart that a French company has fashioned in part from cow tissue will soon be tested in human patients.
科學家一直在尋找一種效率與天然心臟相同而且耐用的人工心臟。現在，一家法國公司以牛體組織為部分材料研發出一款人工心臟，很快就會進入人體實驗階段。
Surfaces in the heart that touch human blood are made from cow tissue instead of artificial materials like plastic that can cause problems like clotting.
這顆心臟接觸人體血液的各表面以牛體組織製成，取代可能引起血栓等後遺症的人工材質。
“The way they’ve incorporated biological surfaces for any place that contacts blood is a really nice advantage,” said Dr. Joseph Rogers, an associate professor at Duke University in Durham, North Carolina, and medical director of its cardiac transplant and mechanical circulatory support program. “If they have this design right, this could be a game changer,” lessening the need for anticoagulation medicines.
羅格斯是北卡羅來納州杜爾罕市杜克大學的副教授，也是該校心臟移植與機械循環輔助研究計畫的醫學主任。他說：「他們把生物表面用在接觸血液的所有地方，是一大優點。如果設計正確，它可能扭轉局面」，同時減少使用抗凝血藥物的必要性。
Fifteen years in development by Carmat, a company based in Paris, the heart has been approved for clinical trials at cardiac surgery centers in Belgium, Poland, Saudi Arabia and Slovenia.
巴黎卡馬特生醫公司研發這種人工心臟已15年，目前已獲准在比利時、波蘭、沙烏地阿拉伯、斯洛維尼亞等地的心臟外科中心做臨床實驗。
In France, where the device is not yet cleared for human implantation, regulators have requested more animal tests; those tests are continuing.
在法國，這種裝置仍未獲准用於人體移植。主管當局要求進行更多動物實驗。這些實驗還在持續中。
This is the first artificial heart to use cow-derived materials – specifically, tissue from the pericardial sac that surrounds the heart. Biological tissue has been used in mechanical blood pumps only in valves, Dr. Rogers said.
這是第一種採用牛體組織的人工心臟。這些組織來自心臟周圍的心包囊。羅格斯表示，此前生物組織在機械血液唧筒中只用於瓣膜。
When the natural heart is partly damaged or diseased, patients might keep it and have a mechanical aid implanted to bolster blood flow. Such pumps – especially those that aid the left side of the heart – are in wide use both as a bridge to a transplant and for lifetime therapy.
天然心臟局部受損或生病時，病人可保留心臟，同時植入機械輔助裝置以促進血液流動。這種唧筒，尤其是輔助左心房的唧筒使用廣泛，可充當移植前的橋梁及終身治療之用。
A totally artificial heart for extended use would be of great value, but it’s far too early to know if the Carmat heart, as yet untried in humans, will be that device.
能長期使用的全人工心臟當然非常珍貴，現階段無法預言尚待進行人體實驗的卡馬特人工心臟是否就是這種裝置。
The cost of the Carmat heart would be about $200,000, said Dr. Piet Jansen, medical director at Carmat. He did not expect it to be brought to market in Europe before the end of 2014.
卡馬特醫學主管簡森博士說，這種人工心臟約需20萬美元，明年底前不太可能在歐洲推出。
The Carmat heart has two chambers, each divided by a membrane. That membrane has cow tissue on one side – the side that is in contact with blood – and polyurethane on the other side, which touches the miniaturized pumping system of motors and hydraulic fluids that changes the membrane’s shape. (The motion of the membrane pushes the blood out to the body.) The embedded electronics and software adjust the rate of blood flow. Patients can wear the batteries under the arm in a holster, or in a belt, among other options.
這種人工心臟有兩個心室，各以一片一側附有牛體組織並與血液接觸，另一側塗有聚氨酯的薄膜隔開。塗有聚氨酯的這一側接觸微型的馬達打氣系統及水力流液，可以改變薄膜的形狀（薄膜作動使血液流到體內）。嵌住的電子裝置與軟體可調整血液的流動。電池有多種穿戴方式，包括置於手臂下的皮套或一條帶子裡。
Cow tissue is also used for the heart’s artificial valves, which were created by Dr. Alain Carpentier, a cardiac surgeon and a pioneer of heart valve repair who is also a founder of Carmat. The cow tissue is chemically treated so that it is sterile and biologically inert.
牛體組織也用於心臟的人工瓣膜。這種瓣膜由心臟外科醫師兼心臟瓣膜修復先驅卡本迪亞發明。他也是卡馬特公司的共同創辦人與科學主任。牛體組織經過化學處理，呈現無菌與無生命狀態。
The device is regulated by sensors, software and microelectronics. And its power will come from two external, wearable lithium-ion batteries.
這種裝置以感應器、軟體及微電子器材調節，電力來自兩個穿戴型的外部鋰電池。
The heart’s design and development relied heavily on aerospace testing strategies by EADS, the European Aeronautic Defense and Space Company, one of Carmat’s backers, Dr. Jansen said.
簡森表示，這種人工心臟的設計與開發非常仰賴歐洲航太集團的太空實驗策略。該集團也是卡馬特公司的贊助機構之一。
He said that one requirement for the heart was that it last five years. The company has been doing bench tests to see whether it can last that long.
他說，人工心臟的必要條件之一是必須可以使用五年。卡馬特公司正在進行台架實驗加以確定。
Dr. Lynne Warner Stevenson, director of the cardiomyopathy and heart-failure program at Brigham and Women’s Hospital in Boston, is optimistic about the new device.
波士頓布萊根婦科醫院心肌症與心臟衰竭研究計畫主任琳‧史迪文森對這種新裝置很樂觀。
“I applaud the pioneers who developed it,” she said.
她說：「我為開發這種人工心臟的先驅們喝采。」
原文參照：
http://www.nytimes.com/2013/07/14/business/the-artificial-heart-is-getting-a-bovine-boost.html
2013-07-30聯合報/G9版/UNITEDDAILYNEWS 陳世欽譯 原文參見紐時週報十版左
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