ILP Quiz

Who devised the concept of Isolated Limb Perfusion (ILP) and in what year

• Creech and associates in 1956
• Johnson and Miller in 1962
• Kaye and Spencer in 1954
• Lee and Carter in 1958
• Harkins and Roberts in 1960

Answer explanation

Creech and associates in 1956

What was the original purpose of Isolated Limb Perfusion (ILP)

• To treat bone marrow cancer
• To treat patients with extremity skin cancer
• To treat metastatic lung tumors
• To prevent systemic spread of infection
• To reduce limb swelling after trauma

Answer explanation

To treat patients with extremity skin cancer

What is the cancer most often treated with Isolated Limb Perfusion (ILP)

• Sarcoma
• Basal cell carcinoma
• Melanoma
• Kaposi’s sarcoma
• Squamous cell carcinoma

Answer explanation

Melanoma

What types of malignancies can be treated with Isolated Limb Perfusion (ILP)

• Only melanoma
• Melanoma, sarcomas, and other limb-confined cancers
• Breast cancer and melanoma
• Sarcomas and lung cancer
• Lymphomas and sarcomas

Answer explanation

Melanoma, sarcomas, and other malignancies confined to the limb

What are the three primary goals of ILP

• Reduce systemic BP, improve oxygenation, shrink tumor
• Isolate extremity, use hyperthermia, prevent systemic chemo spread
• Isolate lung function, use cooling, deliver antibiotics
• Increase heart output, reduce swelling, limit pain
• Increase renal filtration, lower heart rate, reduce blood volume

Answer explanation

Isolate the extremity from systemic circulation, use hyperthermia, and prevent systemic access of high-dose chemotherapy agents

What role does the oxygenator play in ILP

• Supplies blood to the systemic circulation
• Provides respiratory support to isolated limb
• Filters chemotherapy drugs
• Maintains constant temperature
• Removes excess carbon dioxide from whole body

Answer explanation

It provides respiratory support to the isolated limb tissues during treatment

What does the heat exchanger and heater-cooler in ILP do

• Induce cooling for nerve protection
• Maintain room temperature
• Induce hyperthermia for chemo efficacy
• Warm the whole body
• Maintain limb oxygenation

Answer explanation

Induce hyperthermia to increase the pharmacologic efficacy of chemotherapy drugs

Why can chemotherapy doses in ILP be 10 times stronger than systemic treatments

• Because metabolism is faster in limbs
• Because vital organs are bypassed
• Because the drugs are injected directly into tumors
• Because blood pressure is higher in extremities
• Because chemo binds better to limb tissue

Answer explanation

Because the limb is isolated from systemic circulation, preventing drug exposure to vital organs

How are chemotherapy drugs removed before tourniquet release in ILP

• By ultrafiltration
• By lymphatic drainage
• By complete limb blood volume drainage
• By systemic dialysis
• By topical cooling

Answer explanation

Through proper perfusion techniques and circuit design that allow complete drainage of the limb's blood volume

What circuit components are ideal for ILP procedures

• Adult-sized components
• Pediatric-sized circuit with reservoir and oxygenator
• Neonatal-sized components
• Large-volume ECMO circuit
• Portable bypass unit

Answer explanation

Pediatric-sized perfusion circuit components including reservoir and oxygenator