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An Open-Source Normothermic Perfusion System Designed for Research Scientists
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Developing a protocol for normothermic ex-situ limb perfusion.

Eliana F R Duraes1, Maria Madajka1, Russell Frautschi1

  • 1Plastic Surgery Department, Cleveland Clinic, Cleveland, Ohio.

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Summary
This summary is machine-generated.

Normothermic ex-situ limb perfusion successfully preserved swine limb viability and function for 12 hours. This technique shows promise for extending organ preservation in transplantation by maintaining physiological conditions.

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Area of Science:

  • Transplantation research
  • Organ preservation techniques
  • Surgical innovation

Background:

  • Ischemia time critically limits extremity transplantation success due to rapid muscle damage.
  • Normothermic ex-situ preservation aims to extend organ viability by mimicking physiological conditions.
  • Developing effective preservation methods is crucial for advancing transplantation outcomes.

Purpose of the Study:

  • To develop and evaluate an ex-situ normothermic limb perfusion system.
  • To assess the preservation of porcine limb viability and function for 12 hours post-procurement.
  • To establish a reliable method for extending limb viability in transplantation contexts.

Main Methods:

  • 18 swine limbs were utilized to develop and optimize the perfusion protocol.
  • Perfusion was conducted at 39°C for 12 hours using oxygenated colloid solution with red blood cells.
  • Limb viability was assessed through muscle contractility, compartment pressure, biochemical markers (CK, myoglobin), NIRS, angiography, and thermography.

Main Results:

  • The optimized protocol successfully perfused 5 limbs for the target 12 hours.
  • Maintained normal compartment pressure (16.4 ± 8.20 mmHg) and minimal weight increase (0.54 ± 7.35%).
  • Muscle contractility persisted throughout perfusion; however, distal perfusion uniformity varied, identified by angiography and thermography.

Conclusions:

  • Ex-situ normothermic limb perfusion effectively preserves swine limb physiology and function for at least 12 hours.
  • This method represents a significant advancement in organ preservation for extremity transplantation.
  • Further refinement may improve perfusion uniformity for enhanced clinical application.