Viability of ischemia/reperfused bone determined at the gene expression level

Rat bone viability was evaluated, using a bone viability index (BVI) that reflects mRNA degradation. To evaluate ischemic injury of the bone, 28 amputated hind limbs of Fischer rats (ischemic insult group: four subgroups, each containing seven limbs) were preserved at normothermia for 1, 3, 6 and 9 hr and the tibiae were harvested. To investigate ischemia/reperfusion injury, another 42 amputated limbs were transplanted to recipient Fischer rats after ischemia at normothermia for 1, 3 and 6 hr, respectively. The tibiae from the transplanted limbs were harvested on day 3 and day 7 after the transplantation (ischemia/reperfusion group). Seven fresh tibiae were also harvested and used as controls (control group). The total RNA isolated from the tibia of each group was fractionated by electrophoresis and hybridized with 32P-labelled cDNA of glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and the radioactivity of intact and degraded GAPDH mRNA was measured. BVI was calculated as follows: BVI = [A/(A + B)] x 100, where A and B represent the radioactivities corresponding to the intact GAPDH and degraded GAPDH mRNA band, respectively. In the 1-hr and 3-hr ischemia groups, the BVIs of the ischemia/reperfused group were comparable to those of controls, although the indexes of the ischemic insult group were significantly lower than controls. However, in the 6-hr ischemia group, indexes of both the ischemic insult and ischemia/reperfusion groups were significantly lower than controls. These results demonstrated that bone damage was detected with ischemia at normothermia even after 1 hr; however, this tissue damage was overcome by reperfusion. There was no recovery from damage in bones that had been preserved for more than 6 hr, resulting in irreversible degeneration. Therefore, in clinical vascularized bone grafts, it appears that transplantation should be done within a 3-hr ischemic period for it to be successful.