Orthotopic Hind-Limb Transplantation in Rats

Sucher, Robert; Oberhuber, Rupert; Margreiter, Christian; Rumberg, Guido; Jindal, Rishi; Lee, WP Andrew; Margreiter, Raimund; Pratschke, Johann; Schneeberger, Stefan; Brandacher, Gerald

doi:10.3791/2022-v

Cited by 3 publications

(2 citation statements)

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“…Further studies and assessments should be later undertaken to better discern the muscular outcomes that could be found when reinnervation is completed. Testing this new perfusion protocol in orthotopically transplanted limbs 44 is therefore an obvious next step.…”

Section: Discussionmentioning

confidence: 99%

Exceeding the Limits of Static Cold Storage in Limb Transplantation Using Subnormothermic Machine Perfusion

Goutard

Vries

Tawa

et al. 2022

J Reconstr Microsurg

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Background For 50 years, static cold storage (SCS) has been the gold standard for solid organ preservation in transplantation. Although logistically convenient, this preservation method presents important constraints in terms of duration and cold ischemia-induced lesions. We aimed to develop a machine perfusion (MP) protocol for the recovery of vascularized composite allografts (VCA) after static cold preservation and determine its effects in a rat limb transplantation model. Methods Partial hindlimbs were procured from Lewis rats and subjected to SCS in HTK solution for 0, 12, 18, 24, and 48 hours. They were then either transplanted (Txp), subjected to subnormothermic machine perfusion (SNMP) for 3 hours with a modified Steen solution or to SNMP+Txp. Perfusion parameters were assessed for blood gas and electrolytes measurement, and flowrate and arterial pressures were monitored continuously. Histology was assessed at the end of perfusion. For select SCS durations, graft survival and clinical outcomes after transplantation were compared between groups at 21 days. Results Transplantation of limbs preserved for 0, 12, 18 and 24-hour SCS resulted in similar survival rates at post-operative day 21. Grafts cold-stored for 48 hours presented delayed graft failure (p=0.0032). SNMP of limbs after 12-hr SCS recovered the vascular resistance, potassium, and lactate levels to values similar to limbs that were not subjected to SCS. However, 18-hr SCS grafts developed significant edema during SNMP recovery. Transplantation of grafts that had undergone a mixed preservation method (12-hr SCS+SNMP+Txp) resulted in better clinical outcomes based on skin clinical scores at day 21 post-transplantation when compared to the SCS+Txp group (p=0.01613). Conclusion To date, VCA machine perfusion is still limited to animal models and no protocols are yet developed for graft recovery. Our study suggests that ex vivo SNMP could help increase the preservation duration and limit cold ischemia-induced injury in VCA transplantation.

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Section: Discussionmentioning

confidence: 99%

Exceeding the Limits of Static Cold Storage in Limb Transplantation Using Subnormothermic Machine Perfusion

Goutard

Vries

Tawa

et al. 2022

J Reconstr Microsurg

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show abstract

“…As the presence of tissue can influence the freezing point, the effect of the addition of partial and whole hindlimbs on the freezing point was assessed for alternative storage solutions using Steen + as a base solution [ 1 ]. Eight hindlimbs, 4 partial [ 19 ] and 4 whole [ 20 ], were procured from Lewis male rats. The limbs were then submerged in 60 mL solution (Steen + with PEG 5% + Trehalose 50 mM + Glycerol varying) in a sealed sterile bag.…”

Section: Methodsmentioning

confidence: 99%

Enhancing Vascularized Composite Allograft Supercooling Preservation: A Multifaceted Approach with CPA Optimization, Thermal Tracking, and Stepwise Loading Techniques

von Reiterdank,

Dinicu,

Cetrulo

et al. 2024

Preprint

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Vascularized composite allografts (VCAs) present unique challenges in transplant medicine, owing to their complex structure and vulnerability to ischemic injury. Innovative preservation techniques are crucial for extending the viability of these grafts, from procurement to transplantation. This study addresses these challenges by integrating cryoprotectant agent (CPA) optimization, advanced thermal tracking, and stepwise CPA loading strategies within an ex vivo rodent model. CPA optimization focused on various combinations, identifying those that effectively suppress ice nucleation while mitigating cytotoxicity. Thermal dynamics were monitored using invasive thermocouples and non-invasive FLIR imaging, yielding detailed temperature profiles crucial for managing warm ischemia time and optimizing cooling rates. The efficacy of stepwise CPA loading versus conventional flush protocols demonstrated that stepwise (un)loading significantly improved arterial resistance and weight change outcomes. In summary, this study presents comprehensive advancements in VCA preservation strategies, combining CPA optimization, precise thermal monitoring, and stepwise loading techniques. These findings hold potential implications for refining transplantation protocols and improving graft viability in VCA transplantation.

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Novel Osteomyocutaneous Flap Model for Vascularized Composite Allotransplantation

Tran,

Cassidy,

Chinta

et al. 2024

JPRAS Open

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Orthotopic Hind-Limb Transplantation in Rats

Cited by 3 publications

References 0 publications

Exceeding the Limits of Static Cold Storage in Limb Transplantation Using Subnormothermic Machine Perfusion

Exceeding the Limits of Static Cold Storage in Limb Transplantation Using Subnormothermic Machine Perfusion

Enhancing Vascularized Composite Allograft Supercooling Preservation: A Multifaceted Approach with CPA Optimization, Thermal Tracking, and Stepwise Loading Techniques

Novel Osteomyocutaneous Flap Model for Vascularized Composite Allotransplantation

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