title: Muscle is a target for preservation in a rat limb replantation model.
abstract: BACKGROUND
  Ischemia exceeding 6 hours makes clinical limb replantation difficult and places the patient at risk of functional deficit or limb loss. We investigated the preservation of muscle function and morphology with solutions in rat hindlimb in vivo and in vitro.
  
  
  METHODS
  Quadriceps femoris muscles from luciferase transgenic rats were preserved for 24 hours at 4°C in extracellular-type trehalose containing Kyoto (ETK), University of Wisconsin (UW), or lactated Ringer's (LR) solution (control). Muscle luminescence was measured with a bioimaging system. Amputated limbs of Lewis rats preserved with ETK, UW, or LR for 6 or 24 hours at 4°C were transplanted orthotopically. At week 8, terminal latency and amplitude were measured in the tibialis anterior muscle. The muscles were also analyzed histologically.
  
  
  RESULTS
  Isolated muscles preserved in ETK or UW had significantly higher luminescence than did muscles immersed in LR (P < 0.05). In the 6-hour-preserved limb transplantation model, although the 3 groups had almost the same terminal latency, electrical amplitude was significantly lower in the LR group. Histologically, muscles preserved with LR showed the most atrophic changes. In the 24-hour-preserved model, the survival rate of the LR group was 37.5% in contrast to 80% in the ETK and UW groups. Electrical signals were not detected in the LR group owing to severe muscle atrophy and fibrosis. The ETK and UW groups showed good muscle function electrophysiologically.
  
  
  CONCLUSIONS
  Preservation solutions can protect muscle function and morphology in ischemia-reperfusion limbs and improve recipient survival rates after transplantation of long-term-preserved limbs.
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan; Division of Development of Advanced Therapy, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan; and Department of Orthopedic Surgery, Tochigi Rehabilitation Center, Tochigi, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Iijima
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan; Division of Development of Advanced Therapy, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan; and Department of Orthopedic Surgery, Tochigi Rehabilitation Center, Tochigi, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Ajiki
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan; Division of Development of Advanced Therapy, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan; and Department of Orthopedic Surgery, Tochigi Rehabilitation Center, Tochigi, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Teratani
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan; Division of Development of Advanced Therapy, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan; and Department of Orthopedic Surgery, Tochigi Rehabilitation Center, Tochigi, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hoshino
authors.affiliation: Department of Orthopedic Surgery, Jichi Medical University, Tochigi, Japan; Division of Development of Advanced Therapy, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan; and Department of Orthopedic Surgery, Tochigi Rehabilitation Center, Tochigi, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kobayashi