{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:05:40Z","timestamp":1792782340751,"version":"4.5.0"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,5,27]],"date-time":"2021-05-27T00:00:00Z","timestamp":1622073600000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Royal College of Surgeons Fellowship","id":[{"id":"https:\/\/ror.org\/02qrg5a24","id-type":"ROR","asserted-by":"crossref"}]},{"name":"British Society for Surgery of the Hand Fellowship","id":[{"id":"https:\/\/ror.org\/03ptf5b24","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Federation of the European Societies for Surgery of the Hand"},{"name":"Centre of Doctoral Training Programme in Regenerative Medicine"},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Manchester Strategic Fund","id":[{"id":"https:\/\/ror.org\/027m9bs27","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Attempts to improve limb preservation for transplantation using ex vivo perfusion have yielded promising results. However, metabolic acidosis, aberrant perfusate biochemistry and significant perfusion-induced oedema are reported universally. Optimizing perfusion protocols is therefore essential for maintaining tissue health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomized, two-stage open preclinical trial design was used to determine the optimal temperature and mean arterial pressure for machine perfusion. Conditions compared were: normothermic machine perfusion at 70\u2009mmHg (NMP-70); subnormothermic perfusion (28\u00b0C) at 70\u2009mmHg; subnormothermic (28\u00b0C) perfusion at 50\u2009mmHg; and hypothermic perfusion (10\u00b0C) at 30\u2009mmHg. Following this, a head-to-head experiment was undertaken comparing the optimal machine perfusion with static cold storage. Paired bilateral limbs (10 in total) were randomized to either 8\u2009h of static cold storage, or 2\u2009h of static cold storage and 6\u2009h of optimal machine perfusion. Both groups of limbs were then reperfused on a circuit primed with matched blood from unrelated donors for 4\u2009h without immunosuppression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>NMP-70 resulted in less tissue injury and stable perfusion biochemistry. Assessing reperfusion outcomes, static cold storage resulted in acidosis with increased lactate and a worsening electrolyte profile, necessitating bolus infusions of bicarbonate to prevent graft loss. Conversely, NMP-70 was associated with haemodynamic and biochemical stability. Histologically, on reperfusion with allogeneic whole blood, limbs subjected to static cold storage exhibited multifocal ischaemic injury and increased inflammation, which was absent with NMP-70. Static cold storage also resulted in significant oedema compared with NMP-70.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Normothermic perfusion resulted in superior graft preservation and less reperfusion injury compared with the current static cold storage protocol.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.11921","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T10:40:07Z","timestamp":1668595207000},"page":"574-582","source":"Crossref","is-referenced-by-count":24,"title":["Randomized preclinical study of machine perfusion in vascularized composite allografts"],"prefix":"10.1093","volume":"108","author":[{"given":"K R","family":"Amin","sequence":"first","affiliation":[{"name":"Ex-Vivo Lab, Manchester , UK"},{"name":"Blond McIndoe Laboratories, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J P","family":"Stone","sequence":"additional","affiliation":[{"name":"Ex-Vivo Lab, Manchester , UK"},{"name":"Transplant Centre, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Kerr","sequence":"additional","affiliation":[{"name":"Ex-Vivo Lab, Manchester , UK"},{"name":"Transplant Centre, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Geraghty","sequence":"additional","affiliation":[{"name":"Ex-Vivo Lab, Manchester , UK"},{"name":"Transplant Centre, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Joseph","sequence":"additional","affiliation":[{"name":"Department of Pathology, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Montero-Fernandez","sequence":"additional","affiliation":[{"name":"Ex-Vivo Lab, Manchester , UK"},{"name":"Department of Pathology, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J K","family":"Wong","sequence":"additional","affiliation":[{"name":"Blond McIndoe Laboratories, Division of Cell Matrix Biology and Regenerative Medicine, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester , UK"},{"name":"Department of Plastic Surgery and Burns, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9366-8955","authenticated-orcid":false,"given":"J E","family":"Fildes","sequence":"additional","affiliation":[{"name":"Ex-Vivo Lab, Manchester , 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