Semin Pediatr Surg
. 2026 Jun 7:151662.
doi: 10.1016/j.sempedsurg.2026.151662. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/42323223/
The EXTra-uterine Environment for Neonatal Development (EXTEND) – future treatment for prematurity and potentially other congenital disease
Julia Wawrla-Zepf 1, Alan W Flake 2
Affiliations Expand
- PMID: 42323223
- DOI: 10.1016/j.sempedsurg.2026.151662
Abstract
The EXtra-uterine Environment for Neonatal Development (EXTEND) was developed to support extremely premature infants (EPIs) with the goal to mimic in-utero conditions as closely as possible and therefore reduce morbidity and mortality associated with organ immaturity and iatrogenic injury caused by current neonatal management. In an animal model using fetal lambs at a gestational age equivalent to EPIs of 22-24 weeks of gestation, EXTEND was able to support fetuses for up to four weeks while enabling normal organ growth, particularly normal lung development. Recent advances in EXTEND have allowed this technology to come closer to clinical translation than ever before. In a broader future context, EXTEND can be viewed as a platform to facilitate treatment of a variety of disorders such as intrauterine growth restriction, congenital heart disease, congenital diaphragmatic hernia, and genetic or cellular disorders where treatment would otherwise carry risk to the mother or require extensive and direct access to the fetus.
Keywords: Congenital diaphragmatic hernia; Congenital heart disease; EXTEND; Intrauterine growth restriction; Prematurity; Prenatal gene therapy.
Copyright © 2026 Elsevier Inc. All rights reserved.
About The Author
