A Method of Studying 'Normal' Function in the Amputated Human Limb Using Perfusion

Developing a protocol for normothermic ex‐situ limb perfusion

“…The first report of ex situ normothermic perfusion with the aim of understanding limb physiology, was published by Delorme in 1964 (Delorme, Shaw, & Austen, ). Amputated human limbs were perfused at the physiologic temperature and pressure with oxygenated whole blood and dextran for 4.5 hours, with preservation of muscle contraction during perfusion and loss upon cooling the limb (Delorme et al, ).…”

Ex Situ Limb Perfusion System to Extend Vascularized Composite Tissue Allograft Survival in Swine

“…24,25 Blood, or hemoglobin as an oxygen carrier, has not been used for decades because of its potential to propagate metabolic overload and stimulate oxidative metabolism. It has been shown on many animal models as well as in the clinical setting that the use of blood as an artificial oxygen carrier is safe and reliable.…”

Preservation of Amputated Extremities by Extracorporeal Blood Perfusion; a Feasibility Study in a Porcine Model

“…Limited blood perfusion experiments have been performed in the early 1960s and 1970s, investigating mainly physiologic aspects of limb salvage in amputated human specimen [30][31][32]. The use of hemoglobin was thereafter abandoned and extremities were washed out [33,34], stored [35][36][37], perfused intermittently [34,38] or continuously [38][39][40] with fluids of different compositions, including physiological saline [41], Ringer Lactate [39], compositions using mannitol [42], and the standard organ preservation solutions University of Wisconsin [34,35,40,[43][44][45] and Euro Collins [33,39,43,45].…”

“…Instead, similar to the early circuit used by Delorme et al [30], a semi-open system was implemented, in which the blood is suctioned from an interposed bag that collects venous blood by passive drainage. The latter system avoids suction damage to the venous tree and allows a direct, visual control of the variable blood reserve, thus outweighing the disadvantage of increased blood/air contact.…”