Morphologic and metabolic study of the effect of oxygenated perfluorochemical perfusion on amputated rabbit limbs

The purpose of this investigation was to examine the effect of oxygenated perfluorochemical perfusion on ischemia injury to skeletal muscle in rabbits. Forty-two hindlimbs of white rabbits were divided into six groups: 3-hr perfusion; 6-hr perfusion; 3-hr hypothermia; 6-hr hypothermia; sham operation without perfusion or hypothermia preservation; and biopsy. Endothelial cells in these muscles were evaluated using electron microphotography. The areas of both the inner and outer sides of cross-sectioned endothelial cells without cell nuclei were measured, and a new "capillary index" was calculated: (outer area--inner area)/outer area. The values of the capillary index in the perfusion groups were similar to those in the biopsy group. However, the values in the hypothermia groups were significantly greater than those in the biopsy group. These measurements suggested that the perfluorochemical perfusion method preserved the capillary endothelial cells in a nearly normal condition. The adenine nucleotides of these muscles were also evaluated. ATP levels in the 6-hr hypothermia group showed a substantial decrease to 57 percent of those in the sham-operated group. The 6-hr perfusion group levels, however, decreased only to 80 percent of those in the sham-operated group. Although application of the oxygenated perfluorochemical perfusion method did not maintain normal ATP levels, the maintenance of ATP levels was clearly higher than levels maintained in the hypothermia-preservation group. These findings suggest that oxygenated perfluorochemical perfusion is a satisfactory method for preserving amputated limbs.