Abstract
Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research.
Highlights
Complete after six hours[3]
To determine potential beneficial effects of extracorporeal perfusion, one muscle flap was used as control, while the other was used in perfusion experiments
Perfusion and oxygenation improve the tissue’s viability and functionality. These results are consistent with our preliminary findings that supplying oxygen while maintaining continuous perfusion reduces the number of apoptotic cells and tissue damage even after one hour ex vivo compared to the clinical standard, which is represented by the unperfused control group[22]
Summary
Complete after six hours[3]. Attempts to prolong tissue viability and functionality that have been delevoped and thoroughly tested in the last decade are quite diversified, including cold storage, warm storage, perfusion with blood or blood-like substitutes[4,5,6,7,8,9,10,11,12,13,14]. Skeletal muscle was chosen because of its high sensitivity to ischemia-related cell damage This way a better understanding of the ongoing tissue damage during ischemia might be achieved by figuring out how conservation parameters e.g. perfusate compositions, nutrients, oxygen supply, intravascular pressure, temperature and drug treatment in general and to what extent each factor individually contributes to the survival of muscle tissue. Different sets of these parameters and their influence on muscle viability and functionality can be tested with relatively low effort and high level of reliability. Combining EP with EFS creates a research tool which allows to investigate influencing factors and simple modifications of active, ongoing conservation protocols online
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