122. Procurement and Preservation by Ex Vivo Perfusion of Porcine Hindlimbs for Vascularized Composite Allotransplantation
Notice bibliographique
Résumé
PURPOSE: Vascularized composite allotransplantaion (VCA) is an emerging reconstructive technique for treating significant soft tissue and skeletal defects presenting functional deficiencies. At present, limb transplant is severely limited by irreversible ischemic damage of highly metabolic skeletal muscle tissue after 3-4 hours, and is highly susceptible to ischemia-reperfusion injury (IRI). To increase clinical feasibility and success of VCA, new preservation techniques are required to prolong storage time before transplantation. The purpose is three-fold: (1) to bridge the translational gap from rodent to human with a new porcine model; (2) to engineer an ex-vivo limb perfusion system; and (3) test various perfusates to find optimal preservation conditions. Prolongation of storage will increase limb transplant accessibility and advance VCA reconstruction. METHODS: Porcine hindlimbs are procured from cadaveric Yorkshire pigs by incising along the inguinal ligament and dissecting down to the femoral vessels and lateral circumflex femoral vessels. Once the femoral pedicle is visualized, lateral circumflex femoral vessels are ligated, soft tissue is circumferentially dissected around the hip joint, the femoral head is dislocated, and the femoral vessels are ligated and cannulated. Control hindlimbs are placed in static cold storage (SCS). Experimental hindlimbs are perfused via a custom closed-circuit bioreactor containing a pulsatile pressure pump, perfusate reservoir, oxygenator, carbogen gas (95% O2, 5% CO2), and a pressure monitor. Limbs are perfused at 300 mL/min. with target physiologic pressure of 80 mmHg. Arterial inflow and arterial outflow are sampled, as well as all tissue components including skin, nerves, muscle, bone and vessel are biopsied at regular intervals for histological assessment of cell structure and death, adequate oxygen delivery, and metabolic changes. RESULTS: Development of the pig hindlimb surgical procurement has yielded a new research model for VCA research extending beyond rodent and forelimb models. The limb retains intact muscle, bone, vasculature, and nerves and vessels are successfully ligated creating the start and end of the closed circuit loop at the femoral artery and vein respectively. Preliminary ex vivo perfusion bioreactor and circuit can carry out perfusion with successful venous outflow. CONCLUSION: The development of surgical porcine hindlimb procurement successfully produced a viable and novel model for studying VCA preservation prolongation and IRI. The successful bioreactor and ex vivo perfusion circuit design serves as a tool to examine different perfusates against an SCS control. Next steps include developing perfusate cocktails for experimental condition with aim to prolong preservation of the porcine hindlimb and analysis for reduction of irreversible ischemia.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».