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Composite Vascularized Allograft Machine Preservation: State of the Art

  • Machine Preservation of the Liver (C Miller and C Quintini, Section Editors)
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Abstract

Purpose of Review

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.

Recent Findings

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.

Summary

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.

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Authors and Affiliations

  1. Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Majid Rezaei, Brian Figueroa, Lynn M. Orfahli, Carlos Ordenana, Antonio Rampazzo & Bahar Bassiri Gharb

  2. Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Henri Brunengraber

  3. Cleveland Clinic Foundation, Department of Gastroenterology, Cleveland Clinic, Cleveland, OH, USA

    Srinivasan Dasarathy

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  1. Majid Rezaei
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Rezaei, M., Figueroa, B., Orfahli, L.M. et al. Composite Vascularized Allograft Machine Preservation: State of the Art. Curr Transpl Rep 6, 265–276 (2019). https://doi.org/10.1007/s40472-019-00263-0

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