Artificial Placenta and Artificial Womb Technologies for Lung and Kidney Failure: A Holistic Perspective.

Preterm birth remains the leading cause of mortality among neonates. Despite improvements in neonatal intensive care over the years, current treatments for lung and kidney failure are highly invasive, associated with lifelong disability, and limit family integration. Artificial womb and artificial placenta technologies offer a promising alternative by providing more tailored and less invasive neonatal care. Although these technologies share some similarities, artificial womb and artificial placenta technologies differ significantly in terms of treatment initiation, treatment environment, and the potential to support family-centered care. Moreover, even though acute kidney injury is common in neonatal extracorporeal membrane oxygenation (ECMO) patients, current artificial placenta and artificial womb devices lack renal support functionality. Most artificial womb and artificial placenta studies focus on the technical feasibility of these technologies based on in-vivo animal tests. However, translation toward envisioned use of these devices in preterm neonates remains mostly underexposed. A comprehensive stakeholder analysis, including parents and caregivers, is critical to the development of socially acceptable artificial placenta and artificial womb systems. This state-of-the-art review provides an overview of conventional neonatal lung and kidney treatments, delineates the differences between artificial womb and placenta technologies, and addresses the technological and ethical challenges in advancing these technologies toward potential clinical implementation.