Gene Expression as Biomarkers of Tissue Viability in Ex Vivo Normothermic Limb Perfusion (EVNLP)

 

Abigail Meyers, BS, Varun Kopparthy, PhD, Jesse Zhan, BS, Payam Sadeghi, MD, Francis Papay, MD, Antonio Rampazzo, MD, PhD, Bahar Bassiri Gharb, MD, PhD

Muscle viability remains the primary focus of limb preservation •Ex vivo normothermic limb perfusion (EVNLP) has been shown to preserve amputated limbs in a near physiologic metabolic state •Transcriptional changes appear earlier than immuno- and histological - Genetic analyses are more sensitive than histology

 

Molecular mechanisms during normothermic perfusion have not been studied •Genetic biomarkers of tissue and DNA damage and hypoxia during EVNLP would allow us to accurately assess cellular injury and suitability of the limb for transplantation •Aim to evaluate the effect of ex vivo normothermic limb perfusion on the transcriptome

 

EVNLP upregulates gene expression compared

to SCS

•The transcriptome also changes over time in

EVNLP, less in SCS

•Differential expression of genes involved in

inflammation, hypoxia, apoptosis,

muscle/tissue repair

•Triggering these pathways early during

perfusion may be beneficial to these limbs at

replantation

•Identification of these molecular markers is

the first step to building a rapid test for limb

viability