Background: Ischemia-reperfusion injury remains a primary concern in upper extremity transplantation. Ex vivo normothermic perfusion (EVNP) enables near-physiological organ preservation, avoiding the deleterious effects of hypoxia and cooling. We investigated the effectiveness of human limb EVNP compared with static cold storage (SCS). Twenty human upper extremities were procured. Ten were perfused at 38°C with an oxygenated red blood cell-based solution, and contralateral limbs served as SCS control (4°C). Infrared thermography and indocyanine green angiography confirmed the presence of peripheral perfusion.
Conclusions: EVNP can overcome the limitations of cold preservation by extending preservation times, enabling limb quality assessment, and allowing limb reconditioning before transplantation.