title: Extracorporeal perfusion of free muscle flaps in a porcine model using a miniaturized perfusion system.
abstract: BACKGROUND
  The development of techniques in transplantation medicine--including various aspects--has made extraordinary progress within the past three decades. However, the transplantation of free tissue flaps with the common problem of limited ischemia time frames remains an area in which the understanding of mechanism during ischemia and reperfusion is still limited. Thus, similar to other organ transplantations, the prolongation of ischemic time and the possibility to perform an ex vivo perfusion is desirable. The purpose of this study was to create a closed and steady ex vivo perfusion system in order to analyze the possibility of using a miniaturized perfusion system for free muscle flaps that could also be clinically used for other solid organ transplantation.
  
  
  METHODS
  The rectus abdominis muscles of six german pigs were used in the study. Each of these free muscle flaps was perfused for a period of 2 h using a pulsatile and closed pump perfusion system by cannulating the arterial and venous vessels of the flap pedicle. During the ex vivo perfusion parameters such as arterial and venous pressures were measured continuously.
  
  
  RESULTS
  A total of six ex vivo, closed and steady perfusions have been successfully performed. The optimal arterial flow rate of ex vivo perfusion of rectus abdominis muscle flaps was evaluated to be 10 ml/min. The constant measurement of arterial (46 ± 13 mmHg) and venous (-1 ± 1 mmHg) pressure in this ex vivo setting showed steady parameters during a period for up to 2 h.
  
  
  CONCLUSIONS
  The data of this study indicate that the ex vivo perfusion of free muscle flaps is technically feasible and a closed and steady circulation is manageable for a period of up to 2 h.
authors.affiliation: Department of Plastic and Hand Surgery, University Hospital, Friedrich-Alexander-University of Erlangen-Nürnberg, Krankenhausstrasse 12, 91054 Erlangen, Germany. adrian.dragu@uk-erlangen.de
authors.forename: Adrian
authors.initials: A
authors.lastname: Dragu
authors.forename: Torsten
authors.initials: T
authors.lastname: Birkholz
authors.forename: Judith Amélie
authors.initials: JA
authors.lastname: Kleinmann
authors.forename: Stefan
authors.initials: S
authors.lastname: Schnürer
authors.forename: Frank
authors.initials: F
authors.lastname: Münch
authors.forename: Robert
authors.initials: R
authors.lastname: Cesnjevar
authors.forename: Joachim
authors.initials: J
authors.lastname: Schmidt
authors.forename: Christian
authors.initials: C
authors.lastname: Taeger
authors.forename: Ulrich
authors.initials: U
authors.lastname: Kneser
authors.forename: Raymund E
authors.initials: RE
authors.lastname: Horch
mesh_terms: D000818:Animals; D058752:Free Tissue Flaps; D018482:Muscle, Skeletal / Q000098:blood supply; D010477:Perfusion / Q000295:instrumentation*; D017568:Rectus Abdominis; D013552:Swine