Current Evidence of Digital and Hand Replantation Following Cold Ischemia or Cryopreservation: A Systematic Review.
Alec J Chen, Elizabeth K Laning, Myiah P Quach et al.
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In 30 seconds
This systematic review examined published outcomes after digit or hand replantation when preservation was at or below 10°C or exceeded 6 hours. Ten manuscripts covering 255 patients and 287 replanted digits or hands were included. Preservation durations ranged from 6 hours to 81 days, with varied temperatures and methods. Overall, 234 of 287 replants survived (81.5%). Two manuscripts described four successful digit replants after cryopreservation at −196°C for up to 81 days. The review concludes that further research into preservation methods is needed before their potential to extend replantation windows can be established.
Key findings
- Overall replantation survival was 81.5% (234/287).
- Preservation lasted 6 to <24 hours for 242/287 replants (84.3%); four cases were preserved for 5 to 81 days.
- Cold ischemia at 0°C to <10°C was reported for 197/287 replants (68.6%).
- Two manuscripts reported four successful digit replants after cryopreservation at −196°C, with preservation up to 81 days.
Why it matters
The review brings together reported outcomes across a wide range of preservation temperatures and durations, including cases beyond conventional ischemic limits. The overall survival figure and long-duration cryopreservation cases indicate that extended preservation has been reported, but the evidence is drawn from a small number of manuscripts and does not establish which methods are reliably effective.
What to keep in mind
The review included only 10 manuscripts, and the evidence spans heterogeneous preservation temperatures and durations. The abstract does not report comparative outcomes by preservation method.