Table 5.

Ex vivo perfusion.

Large Animal Model	VCA model	IS	Experimental Groups	Results/Conclusions	Reference
Swine	Orthotopic forelimb VCA	None	Group 1 – limbs were perfused for 12 hours using warm (27°C-32°C) autologous blood.	Warm perfusion with autologous blood led to acceptable levels of microvascular blood flow and near normal muscle contractility after transplantation up to 24 hours as well as stable physiological parameters: K+, pH, pO2, and pCO2.	(72)
			Group 2 – cold preservation control group, preserving limbs for 6 hours at 4°C. Following perfusion, limbs were transplanted into healthy swine
Swine	Orthotopic forelimb VCA	None	Group 1 – (control) Limbs were perfused with heparin solution and preserved at 4°C for 6 hours.	Ex vivo warm perfusion of swine forelimb grafts for 12-24 hours improved microvascular blood flow and functional outcomes compared to static cold storage.	(73)
			Group 2 - Limbs were perfused with autologous blood at 27°C to 32°C for 24 hours. Following perfusion, limbs were transplanted into healthy swine.
Swine	Forelimb VCA	None	Group 1 – Amputated limbs were perfused for 12 hours using an oxygenated colloid solution at 38°C containing washed RBCs;	Outcomes of extended normothermic preservation (EVNLP) of limbs up to 44 hours are not significantly different from short EVNLP (12 hours).	(74)
			Group 2 – Limbs were perfused until the vascular resistance increased (up to 44 hours). Contralateral forelimbs in each group were preserved at 4°C as a cold storage control group. Limbs were not transplanted.

IS, immunosuppression; RBC, red blood cells; VCA, vascularized composite allotransplant.