Composite Vascularized Allograft Machine Preservation: State of the Art

Abstract

In this review, we aim to introduce the concept of machine perfusion of vascularized composite allografts (VCAs). We briefly discuss the basic elements of the circuit design, role of the temperature during the perfusion, types of perfusate, and future trends in this field. Several large animal models have demonstrated the efficacy of machine perfusion over static cold storage. While the maximum allowable ischemia time in VCA is 4–6 h with cold storage method, promising results have been achieved in extended preservation times up to 24 h in machine perfusion technique. Current evidence shows that machine perfusion of VCA can overcome the limitations of static cold storage technique and not only can be considered as a preservation but also as a diagnostic and therapeutic method for the practice of replantation/transplantation.