{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:08:07Z","timestamp":1779300487139,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2020,3,22]],"date-time":"2020-03-22T00:00:00Z","timestamp":1584835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Ischemia and reperfusion injury remains a significant limiting factor for the successful revascularization of amputated extremities. Ex vivo normothermic perfusion is a novel approach to prolong the viability of the amputated limbs by maintaining physiologic cellular metabolism. This study aimed to evaluate the outcomes of extended ex vivo normothermic limb perfusion (EVNLP) in preserving the viability of amputated limbs for over 24 hours. A total of 10 porcine forelimbs underwent EVNLP. Limbs were perfused using an oxygenated colloid solution at 38\u00b0C containing washed RBCs. Five forelimbs (Group A) were perfused for 12 hours and the following 5 (Group B) until the vascular resistance increased. Contralateral forelimbs in each group were preserved at 4\u00b0C as a cold storage control group. Limb viability was compared between the 2 groups through assessment of muscle contractility, compartment pressure, tissue oxygen saturation, indocyanine green (ICG) angiography and thermography. EVNLP was performed for 12 hours in group A and up to 44 hours (24\u201044 hours) in group B. The final weight increase (\u22121.28\u00a0\u00b1\u00a08.59% vs. 7.28\u00a0\u00b1\u00a015.05%, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.548) and compartment pressure (16.50\u00a0\u00b1\u00a08.60 vs. 24.00\u00a0\u00b1\u00a09.10) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.151) were not significantly different between the two groups. Final myoglobin and CK mean values in group A and B were: 875.0\u00a0\u00b1\u00a0325.8 ng\/mL (A) versus 1133.8\u00a0\u00b1\u00a0537.7 ng\/mL (B) (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.056) and 53\u00a0344.0\u00a0\u00b1\u00a016\u00a0603.0 U\/L versus 64\u00a0333.3\u00a0\u00b1\u00a032\u00a0481.8 U\/L (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.286). Tissue oxygen saturation was stable until the end in both groups. Infra\u2010red thermography and ICG\u2010angiography detected variations of peripheral limb perfusion. Our results suggest that extended normothermic preservation of amputated limbs is feasible and that the outcomes of prolonged EVNLP (&gt;24\u00a0hours) are not significantly different from short EVNLP (12\u00a0hours).<\/jats:p>","DOI":"10.1111\/aor.13678","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T07:21:55Z","timestamp":1583392915000},"page":"846-855","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Extended ex vivo normothermic perfusion for preservation of vascularized composite allografts"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4315-7932","authenticated-orcid":false,"given":"Vahe","family":"Fahradyan","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sayf Al\u2010deen","family":"Said","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Ordenana","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Dalla Pozza","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Russell","family":"Frautschi","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana F. R.","family":"Duraes","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Madajka\u2010Niemeyer","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank A.","family":"Papay","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Rampazzo","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahar","family":"Bassiri Gharb","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland OH USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481908500628"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-017-0168-3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/MOT.0000000000000567","article-title":"Advances in machine perfusion, organ preservation, and cryobiology: potential impact on vascularized composite allotransplantation","volume":"23","author":"Burlage LC","year":"2018","journal-title":"Curr Opin Organ Transplant."},{"key":"e_1_2_7_5_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/S0749-0712(21)00519-9","article-title":"Major upper limb replantation","volume":"17","author":"Chew WY","year":"2001","journal-title":"Hand Clin."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0967-2109(02)00070-4"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e3181b0bb37"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199205000-00001"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/micr.30252"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2010.01.040"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.11.003"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.25005"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trre.2011.02.004"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000756"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2016.05.011"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.10.004"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2009.01.021"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOT.0000000000000471"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.24672"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.5301\/ijao.5000586"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000382"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12727"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(94)70035-4"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-198211000-00002"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1006\/phrs.1999.0653"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-196809000-00008"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00186863"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000000681"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003208"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60261-6"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2018.1430568"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-198811000-00007"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001500"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Faor.13678","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13678","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aor.13678","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.13678","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T18:48:29Z","timestamp":1693853309000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.13678"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,22]]},"references-count":32,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1111\/aor.13678"],"URL":"https:\/\/doi.org\/10.1111\/aor.13678","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,22]]},"assertion":[{"value":"2019-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-02-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-22","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}