Isolated limb perfusion: A literature review

Abstract

Through patient education, biological research, and technological advances, the rate of many cancers in the United States of America is declining. However, the incidence of melanoma is rising steadily, as are the efforts and resources allocated to its treatment. Isolated limb perfusion, ILP, is a standard of care for treating recurrent malignant melanoma confined to a limb. Although an extracorporeal procedure, only a small percentage of perfusionists are experienced regarding ILP's indications and performance techniques. Use of ILP may increase as the incidence of melanoma increases. This two-part review is designed to familiarize the perfusionist with the procedure and the disease it treats. Part I reviews the history of isolated limb perfusion, the diagnosis and classification of malignant melanoma, and the applicability of ILP in its treatment. Part II details a procedural overview and technical considerations of the therapy from the perfusionist perspective. The review concludes with patient selection, outcomes, and the future of ILP as well as other applications for the hyperthermic regional delivery of chemotherapy using extracorporeal technology.