Safety and feasibility of high-pressure transvenous limb perfusion with 0.9% saline in human muscular dystrophy

Zheng Fan, Keith Kocis, Robert Valley, James F. Howard, Manisha Chopra, Hongyu An, Weili Lin, Joseph Muenzer, William Powers

Research output: Contribution to journalArticlepeer-review

41 Scopus citations

Abstract

We evaluated safety and feasibility of the transvenous limb perfusion gene delivery method in muscular dystrophy. A dose escalation study of single limb perfusion with 0.9% saline starting with 5% of limb volume was carried out in adults with muscular dystrophies under intravenous analgesia/anesthesia. Cardiac, vascular, renal, muscle, and nerve functions were monitored. A tourniquet was placed above the knee with inflated pressure of 310 mm Hg. Infusion was carried out with a clinically approved infuser via an intravenous catheter inserted in the saphenous vein with a goal infusion rate of 80 ml/ minute. Infusion volume was escalated stepwise to 20% limb volume in seven subjects. No subject complained of any post procedure pain other than due to needle punctures. Safety warning boundaries were exceeded only for transient depression of limb tissue oximetry and transient elevation of muscle compartment pressures; these were not associated with nerve, muscle, or vascular damage. Muscle magnetic resonant imaging (MRI) demonstrated fluid accumulation in muscles of the perfused lower extremity. High-pressure retrograde transvenous limb perfusion with saline up to 20% of limb volume at above infusion parameters is safe and feasible in adult human muscular dystrophy. This study will serve as a basis for future gene transfer clinical trials.

Original languageEnglish
Pages (from-to)456-461
Number of pages6
JournalMolecular Therapy
Volume20
Issue number2
DOIs
StatePublished - Feb 2012

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