gms | German Medical Science

47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC)

08.09. - 10.09.2016, Kassel

Article

Send article

Acellular hypothermic extracorporeal perfusion extends allowable ischemia time in a porcine whole limb replantation model

Extrakorporale azelluläre Maschinenperfusion verlängert mögliche Ischämiezeit in einem porkinen Extremitätenreplantationsmodell

Meeting Abstract

Search Medline for

  • presenting/speaker Maximilian Kückelhaus - Bergmannsheil, Bochum, Deutschland
  • Alexander Dermietzel - Bergmannsheil, Bochum, Deutschland
  • Sebastian Fischer - BG Universitätsklinikum, Ludwigshafen, Deutschland
  • Muayyad Alhefzi - Brigham and Women\'s Hospital, Boston, Vereinigte Staaten von Amerika
  • Mario Aycart - Brigham and Women\'s Hospital, Boston, Vereinigte Staaten von Amerika
  • Nicco Krezdorn - Brigham and Women\'s Hospital, Boston, Vereinigte Staaten von Amerika
  • Tobias Hirsch - Bergmannsheil, Bochum, Deutschland
  • Bohdan Pomahac - Brigham and Women\'s Hospital, Boston, Vereinigte Staaten von Amerika

Deutsche Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen. Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen. 47. Jahrestagung der Deutschen Gesellschaft der Plastischen, Rekonstruktiven und Ästhetischen Chirurgen (DGPRÄC), 21. Jahrestagung der Vereinigung der Deutschen Ästhetisch-Plastischen Chirurgen (VDÄPC). Kassel, 08.-10.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc048

doi: 10.3205/16dgpraec048, urn:nbn:de:0183-16dgpraec0481

Published: September 27, 2016

© 2016 Kückelhaus et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Background: One of the major challenges in traumatic amputations (TA) is the need to maintain ischemia time brief (4-6h) in order to avoid ischemic damage and enable successful replantation. Our inability to meet this challenge often leads to traumatic limb loss, which has a considerable detrimental impact on the quality of life of patients.

Methods: Our team built a portable extracorporeal membrane oxygenator device for the perfusion of amputated extremities with oxygenated acellular solution under controlled parameters. We amputated forelimbs of Yorkshire pigs, perfused them ex vivo with acellular Perfadex® solution for 12 hours at 10°C in our device and subsequently replanted them into the host animal. We used limbs stored on ice slurry for 4 hours before replantation as our control group.

Results: Clinical observation and histopathological evaluation both demonstrated that there was less morbidity and less tissue damage to the cells during preservation and after replantation in the perfusion group when compared to the standard of care. Significant differences in blood markers of muscle damage and tissue cytokine levels underscored these findings.

Conclusion: We demonstrated the feasibility and superiority of ex vivo hypothermic oxygenated machine perfusion for preservation of amputated limbs over conventional static cold storage and herewith a substantial extension of the allowable ischemia time for replantation after traumatic amputations. This approach could also be applied to the field of transplantation expanding the potential pool of viable donor vascularized composite allografts.