Normothermic machine perfusion in the preservation of amputated limbs: A review of research progress

The success of replantation for amputated limbs is limited by the short safe preservation time of static cold storage and issues like ischemia-reperfusion injury. Normothermic machine perfusion (NMP) represents a revolutionary advancement with the potential to overcome these limitations, demonstrating considerable potential in extending preservation time, improving preservation quality, and enabling viability assessment. This study comprehensively reviews the technical principles and theoretical advantages of NMP. Through comparative analysis with static cold storage and hypothermic oxygenated machine perfusion, its unique value is elucidated. The review then focuses on summarizing experimental research findings from large animal models and human amputated limb models. Finally, it discusses future research directions, such as perfusate optimization, assessment system development, and exploration of NMP as a therapeutic platform, along with prospects for clinical application.